Risk assessment, prognosis and guideline implementation in pulmonary arterial hypertension
Risk assessment, prognosis and guideline implementation in pulmonary arterial hypertension
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DOI：
10.1183/13993003.00889-2017
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发表时间：
2017-08-01
影响因子：
24.3
通讯作者：
Sitbon, Olivier
中科院分区：
文献类型：
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作者：
Boucly, Athenais;Weatherald, Jason;Sitbon, Olivier
目前的欧洲指南建议对肺动脉高压（PAH）患者进行定期风险评估。我们研究的目的是确定诊断后1年内达到的低风险标准数量与长期预后之间的关系。分析了2006 - 2016年特发性、遗传性和药物性PAH的发病情况。评估诊断和首次重新评估时存在的低风险标准的数量：世界卫生组织(WHO)/纽约心脏协会（NYHA）功能等级I或II， 6分钟步行距离(6MWD) >440 m，右房压= 2.5 l min(-1).m（-2）。纳入1017例患者（平均年龄57岁，59%为女性，75%为特发性PAH）。中位随访34个月后，238例（23%）患者死亡。在第一次重新评估时，四个低风险标准中的每一个都独立地预测了无移植生存。诊断时出现的低风险标准的数量(p
Current European guidelines recommend periodic risk assessment for patients with pulmonary arterial hypertension (PAH). The aim of our study was to determine the association between the number of low-risk criteria achieved within 1 year of diagnosis and long-term prognosis.Incident patients with idiopathic, heritable and drug-induced PAH between 2006 and 2016 were analysed. The number of low-risk criteria present at diagnosis and at first re-evaluation were assessed: World Health Organization (WHO)/New York Heart Association (NYHA) functional class I or II, 6-min walking distance (6MWD) >440 m, right atrial pressure = 2.5 L.min(-1).m(-2).1017 patients were included (mean age 57 years, 59% female, 75% idiopathic PAH). After a median follow-up of 34 months, 238 (23%) patients had died. Each of the four low-risk criteria independently predicted transplant-free survival at first re-evaluation. The number of low-risk criteria present at diagnosis (p