Risk stratification and response to therapy in patients with pulmonary arterial hypertension and comorbidities: A COMPERA analysis.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Rosenkranz Stephan, Pausch Christine, Coghlan John G, Huscher Doerte, Pittrow David, Grünig Ekkehard, Staehler Gerd, Vizza Carmine Dario, Gall Henning, Distler Oliver, Delcroix Marion, Ghofrani Hossain A, Ewert Ralf, Kabitz Hans-Joachim, Skowasch Dirk, Behr Juergen, Milger Katrin, Halank Michael, Wilkens Heinrike, Seyfarth Hans-Jürgen, Held Matthias, Scelsi Laura, Neurohr Claus, Vonk-Noordegraaf Anton, Ulrich Silvia, Klose Hans, Claussen Martin, Eisenmann Stephan, Schmidt Kai-Helge, Remppis Bjoern Andrew, Skride Andris, Jureviciene Elena, Gumbiene Lina, Miliauskas Skaidrius, Löffler-Ragg Judith, Lange Tobias J, Olsson Karen M, Hoeper Marius M, Opitz Christian
Аннотация
METHODS: We assessed the database of COMPERA, a European pulmonary hypertension registry, to determine changes after initiation of PAH therapy in WHO functional class (FC), 6-minute walking distance (6MWD), brain natriuretic peptide (BNP) or N-terminal fragment of probrain natriuretic peptide (NT-pro-BNP), and mortality risk assessed by a 4-strata model in patients with IPAH and no comorbidities, 1-2 comorbidities and 3-4 comorbidities.
RESULTS: The analysis was based on 1,120 IPAH patients (n = 208 [19%] without comorbidities, n = 641 [57%] with 1-2 comorbidities, and n = 271 [24%] with 3-4 comorbidities). Improvements in FC, 6MWD, BNP/NT-pro-BNP, and mortality risk from baseline to first follow-up were significantly larger in patients with no comorbidities than in patients with comorbidities, while they were not significantly different in patients with 1-2 and 3-4 comorbidities. The 4-strata risk tool predicted survival in patients without comorbidities as well as in patients with 1-2 or 3-4 comorbidities.
CONCLUSIONS: Our data suggest that patients with IPAH and comorbidities benefit from PAH medication with improvements in FC, 6MWD, BNP/NT-pro-BNP, and mortality risk, albeit to a lesser extent than patients without comorbidities. The 4-strata risk tool predicted outcome in patients with IPAH irrespective of the presence of comorbidities.