Analysis of pulmonary hypertension patient survival after treatment in referral center (data of first Ukrainian register)

Radchenko, G.; Zhyvylo, I. О.; Sirenko, Yuriy

doi:10.1177/2045894019845604

Cited by 10 publications

(8 citation statements)

References 32 publications

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“…Regardless of different etiology and clinical classification, PH is associated with progressive impaired right heart function and poor prognosis. Current targeted treatment for pulmonary arterial hypertension (PAH) appears to improve clinical outcomes in modern registries compared to historical controls, 2–7 but the mortality of PH patients is still relatively high.…”

Section: Introductionmentioning

confidence: 99%

The spectrum and prevalence of arrhythmia in different clinical pulmonary hypertension groups in Chinese population

Xue

Yang

Zhao

et al. 2022

Clinical Cardiology

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Background Arrhythmia is not uncommon among pulmonary hypertension (PH) population, and may be associated with disease severity. Hypothesis To investigate different spectrums and prevalence of arrhythmias in different clinical PH groups in Chinese population. Methods Patients diagnosed with PH between April 15, 2019, and August 2, 2021, were enrolled prospectively. The prevalence of different types of arrhythmias in PH patients were calculated. Logistic regression analyses were conducted to determine independent predictors for arrhythmia. Results One thousand patients were enrolled. The prevalence of any arrhythmia, sinus node dysfunction, sinus tachycardia, atrial fibrillation, atrial flutter, other types of atrial tachycardia, atrioventricular block, and ventricular tachycardia is 44.4%, 12.2%, 15.2%, 8.1%, 4.1%, 10.2%, 7.1%, and 2.5%. Logistic regression analyses revealed that older age and larger right ventricle (odds ratio: 1.111 and 1.095, p < .05) were independently related with higher probability of supraventricular arrhythmia; Complicating with coronary artery disease, larger right ventricle, and increased left ventricular end‐diastolic diameter (odds ratio: 19.540, 1.106, and 1.085, p < .05) were independently correlated with sinus node dysfunction/atrioventricular block in patients with pulmonary arterial hypertension. Conclusions Nearly half of PH patients experienced at least one type of arrhythmia. The most common seen arrhythmias were supraventricular arrhythmia, sinus tachycardia, and sinus node dysfunction. Older age and larger right ventricle were independently related with higher probability of supraventricular arrhythmia; Complicating with coronary artery disease, larger right ventricle and increased left ventricular end‐diastolic diameter were independently correlated with higher probability of sinus node dysfunction/atrioventricular block in patients with pulmonary arterial hypertension.

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Section: Introductionmentioning

confidence: 99%

The spectrum and prevalence of arrhythmia in different clinical pulmonary hypertension groups in Chinese population

Xue

Yang

Zhao

et al. 2022

Clinical Cardiology

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“…The group of CTEPH patients was well characterized in a large prospective international registry which enrolled patients between February 2007 and January 2009. 7 As the phenotype of CTEPH patients may be population dependent, 8 several national reports as summarized in Table 1 7 , 9 – 29 were of added value. Most of them, however, recruited patients before the marketing authorization of riociguat by the European Medicines Agency through the European Union (27/03/2014), and before the first experience with balloon pulmonary angioplasty (BPA) outside of Japan.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and outcomes of patients with chronic thromboembolic pulmonary hypertension in the era of modern therapeutic approaches: data from the Polish multicenter registry (BNP-PL)

Kopeć

Dzikowska-Diduch

Mroczek

et al. 2021

Therapeutic Advances in Chronic Disease

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Background: Significant achievements in the treatment of chronic thromboembolic pulmonary hypertension (CTEPH) have provided effective therapeutic options for most patients. However, the true impact of the changed landscape of CTEPH therapies on patients’ management and outcomes is poorly known. We aimed to characterize the incidence, clinical characteristics, and outcomes of CTEPH patients in the modern era of CTEPH therapies. Methods: We analyzed the data of CTEPH adults enrolled in the prospective multicenter registry. Results: We enrolled 516 patients aged 63.8 ± 15.4 years. The incidence rate of CTEPH was 3.96 per million adults per year. The group was burdened with several comorbidities. New oral anticoagulants ( n = 301; 58.3%) were preferred over vitamin K antagonists ( n = 159; 30.8%). Pulmonary endarterectomy (PEA) was performed in 120 (23.3%) patients and balloon pulmonary angioplasty (BPA) in 258 (50%) patients. PEA was pretreated with targeted pharmacotherapy in 19 (15.8%) patients, and BPA in 124 (48.1%) patients. Persistent CTEPH was present in 46% of PEA patients and in 65% of patients after completion of BPA. Persistent CTEPH after PEA was treated with targeted pharmacotherapy in 72% and with BPA in 27.7% of patients. At a mean time period of 14.3 ± 5.8 months, 26 patients had died. The use of PEA or BPA was associated with better survival than the use of solely medical treatment. Conclusions: The modern population of CTEPH patients comprises mostly elderly people significantly burdened with comorbid conditions. This calls for treatment decisions that are tailored individually for every patient. The combination of two or three methods is currently a frequent approach in the treatment of CTEPH. Clinical Trial Registration: clinicaltrials.gov/ct2/show/NCT03959748

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“…17 Similarly, a low percentage of patients undergoing PEA or BPA was also revealed in other developing countries. 18,19 It is difficult to obtain riociguat and treprostinil in these countries. Thus, there is still demand for the off-label PAH drugs.…”

Section: Discussionmentioning

confidence: 99%

Effect of off‐label targeted drugs on long‐term survival in chronic thromboembolic pulmonary hypertension: Insights from a national multicentre prospective registry

Xia,

Qian,

Lin

et al. 2024

Respirology

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Background and ObjectiveOff‐label pulmonary arterial hypertension (PAH)‐targeted drugs are commonly prescribed for non‐operated chronic thromboembolic pulmonary hypertension (CTEPH), but their effect on the long‐term prognosis of CTEPH remains unknown. This study investigated the effect of off‐label PAH‐targeted drugs on the long‐term survival of CTEPH patients.MethodsCTEPH patients were enrolled from a prospective multicentre national registry. Except for licensed riociguat and treprostinil, other PAH‐targeted drugs were off‐label. In the original and propensity score–matched (PSM) samples, five‐year survival was compared in two groups: (a) patients not receiving off‐label PAH‐targeted drugs (control) versus (b) patients receiving off‐label PAH‐targeted drugs (treatment). The latter group was investigated for the effect of started off‐label PAH‐targeted drugs at baselines (initial) or during follow‐up (subsequent).ResultsOf 347 enrolled patients, 212 were treated with off‐label PAH‐targeted drugs initially (n = 173) or subsequently (n = 39), and 135 were untreated. The 1‐, 2‐, 3‐ and 5‐year survival of the treatment group was significantly higher than that of the control group (97.1% vs. 89.4%, 92.3% vs. 82.1%, 83.2% vs. 75.1% and 71.1% vs. 55.3%, respectively, log‐rank test, p = 0.005). Initial treatment was correlated with better 5‐year survival after excluding patients with subsequent treatment to reduce the immortal‐time bias (hazard ratio: 0.611; 95% CI: 0.397–0.940; p = 0.025). In PSM samples, patients given initial treatment showed significantly better 5‐year survival than untreated patients (68.9% vs. 49.3%, log‐rank test, p = 0.008).ConclusionOff‐label targeted drugs contributed to improved long‐term survival in CTEPH patients receiving pharmacotherapies.image

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Analysis of pulmonary hypertension patient survival after treatment in referral center (data of first Ukrainian register)

Cited by 10 publications

References 32 publications

The spectrum and prevalence of arrhythmia in different clinical pulmonary hypertension groups in Chinese population

The spectrum and prevalence of arrhythmia in different clinical pulmonary hypertension groups in Chinese population

Characteristics and outcomes of patients with chronic thromboembolic pulmonary hypertension in the era of modern therapeutic approaches: data from the Polish multicenter registry (BNP-PL)

Effect of off‐label targeted drugs on long‐term survival in chronic thromboembolic pulmonary hypertension: Insights from a national multicentre prospective registry

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