TY - JOUR
T1 - Mortality in pulmonary arterial hypertension
T2 - Prediction by the 2015 European pulmonary hypertension guidelines risk stratification model
AU - Hoeper, Marius M.
AU - Kramer, Tilmann
AU - Pan, Zixuan
AU - Eichstaedt, Christina A.
AU - Spiesshoefer, Jens
AU - Benjamin, Nicola
AU - Olsson, Karen M.
AU - Meyer, Katrin
AU - Vizza, Carmine Dario
AU - Vonk-Noordegraaf, Anton
AU - Distler, Oliver
AU - Opitz, Christian
AU - Gibbs, J. Simon R.
AU - Delcroix, Marion
AU - Ghofrani, H. Ardeschir
AU - Huscher, Doerte
AU - Pittrow, David
AU - Rosenkranz, Stephan
AU - Grünig, Ekkehard
PY - 2017/8/1
Y1 - 2017/8/1
N2 - The 2015 European pulmonary hypertension (PH) guidelines propose a risk stratification strategy for patients with pulmonary arterial hypertension (PAH). Low-, intermediate- and high-risk strata are defined by estimated 1-year mortality risks of <5%, 5-10% and >10%, respectively. This risk assessment strategy awaits validation. We analysed data from patients with newly diagnosed PAH enrolled into COMPERA (Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension), a European-based PH registry. An abbreviated version of the risk assessment strategy proposed by the European PH guidelines was applied, using the following variables: World Health Organization functional class, 6-min walking distance, brain natriuretic peptide or its N-terminal fragment, right atrial pressure, cardiac index and mixed venous oxygen saturation. Data from 1588 patients were analysed. Mortality rates were significantly different between the three risk strata (p<0.001 for all comparisons). In the entire patient population, the observed mortality rates 1 year after diagnosis were 2.8% in the low-risk cohort (n=196), 9.9% in the intermediate-risk cohort (n=1116) and 21.2% in the high-risk cohort (n=276). In addition, the risk assessment strategy proved valid at follow-up and in major PAH subgroups. An abbreviated version of the risk assessment strategy proposed by the current European PH guidelines provides accurate mortality estimates in patients with PAH.
AB - The 2015 European pulmonary hypertension (PH) guidelines propose a risk stratification strategy for patients with pulmonary arterial hypertension (PAH). Low-, intermediate- and high-risk strata are defined by estimated 1-year mortality risks of <5%, 5-10% and >10%, respectively. This risk assessment strategy awaits validation. We analysed data from patients with newly diagnosed PAH enrolled into COMPERA (Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension), a European-based PH registry. An abbreviated version of the risk assessment strategy proposed by the European PH guidelines was applied, using the following variables: World Health Organization functional class, 6-min walking distance, brain natriuretic peptide or its N-terminal fragment, right atrial pressure, cardiac index and mixed venous oxygen saturation. Data from 1588 patients were analysed. Mortality rates were significantly different between the three risk strata (p<0.001 for all comparisons). In the entire patient population, the observed mortality rates 1 year after diagnosis were 2.8% in the low-risk cohort (n=196), 9.9% in the intermediate-risk cohort (n=1116) and 21.2% in the high-risk cohort (n=276). In addition, the risk assessment strategy proved valid at follow-up and in major PAH subgroups. An abbreviated version of the risk assessment strategy proposed by the current European PH guidelines provides accurate mortality estimates in patients with PAH.
UR - http://www.scopus.com/inward/record.url?scp=85027880242&partnerID=8YFLogxK
U2 - https://doi.org/10.1183/13993003.00740-2017
DO - https://doi.org/10.1183/13993003.00740-2017
M3 - Article
C2 - 28775047
SN - 0903-1936
VL - 50
JO - European respiratory journal
JF - European respiratory journal
IS - 2
M1 - 1700740
ER -