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Longitudinal changes in risk status in pulmonary arterial hypertension

AIMS: Low‐risk status in pulmonary arterial hypertension (PAH) predicts better survival. The present study aimed to describe changes in risk status and treatment approaches over multiple clinical assessments in PAH, taking age and comorbidity burden into consideration. METHODS AND RESULTS: The study...

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Autores principales: Bouzina, Habib, Rådegran, Göran, Butler, Oisin, Hesselstrand, Roger, Hjalmarsson, Clara, Holl, Katsiaryna, Jansson, Kjell, Klok, Rogier, Söderberg, Stefan, Kjellström, Barbro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835578/
https://www.ncbi.nlm.nih.gov/pubmed/33305545
http://dx.doi.org/10.1002/ehf2.13162
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author Bouzina, Habib
Rådegran, Göran
Butler, Oisin
Hesselstrand, Roger
Hjalmarsson, Clara
Holl, Katsiaryna
Jansson, Kjell
Klok, Rogier
Söderberg, Stefan
Kjellström, Barbro
author_facet Bouzina, Habib
Rådegran, Göran
Butler, Oisin
Hesselstrand, Roger
Hjalmarsson, Clara
Holl, Katsiaryna
Jansson, Kjell
Klok, Rogier
Söderberg, Stefan
Kjellström, Barbro
author_sort Bouzina, Habib
collection PubMed
description AIMS: Low‐risk status in pulmonary arterial hypertension (PAH) predicts better survival. The present study aimed to describe changes in risk status and treatment approaches over multiple clinical assessments in PAH, taking age and comorbidity burden into consideration. METHODS AND RESULTS: The study included incident patients from the Swedish PAH registry, diagnosed with PAH in 2008–2019. Group A (n = 340) were ≤75 years old with <3 comorbidities. Group B (n = 163) were >75 years old with ≥3 comorbidities. Assessments occurred at baseline, first‐year (Y1) and third‐year (Y3) follow‐ups. The study used an explorative and descriptive approach. Group A: median age was 65 years, 70% were female, and 46% had no comorbidities at baseline. Baseline risk assessment yielded low (23%), intermediate (66%), and high risk (11%). Among patients at low, intermediate, or high risk at baseline, 51%, 18%, and 13%, respectively, were at low risk at Y3. At baseline, monotherapy was the most common therapy among low (68%) and intermediate groups (60%), while dual therapy was the most common among high risk (69%). In patients assessed as low, intermediate, or high risk at Y1, 66%, 12%, and 0% were at low risk at Y3, respectively. Of patients at intermediate or high risk at Y1, 35% received monotherapy and 13% received triple therapy. In low‐risk patients at Y1, monotherapy (40%) and dual therapy (43%) were evenly distributed. Group B: median age was 77 years, 50% were female, and 44% had ≥3 comorbidities at baseline. At baseline, 8% were at low, 80% at intermediate, and 12% at high risk. Monotherapy was the most common therapy (62%) in Group B at baseline. Few patients maintained or reached low risk at follow‐ups. CONCLUSIONS: Most patients with PAH did not meet low‐risk criteria during the 3 year follow‐up. The first year from diagnosis seems important in defining the longitudinal risk status.
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spelling pubmed-78355782021-02-01 Longitudinal changes in risk status in pulmonary arterial hypertension Bouzina, Habib Rådegran, Göran Butler, Oisin Hesselstrand, Roger Hjalmarsson, Clara Holl, Katsiaryna Jansson, Kjell Klok, Rogier Söderberg, Stefan Kjellström, Barbro ESC Heart Fail Original Research Articles AIMS: Low‐risk status in pulmonary arterial hypertension (PAH) predicts better survival. The present study aimed to describe changes in risk status and treatment approaches over multiple clinical assessments in PAH, taking age and comorbidity burden into consideration. METHODS AND RESULTS: The study included incident patients from the Swedish PAH registry, diagnosed with PAH in 2008–2019. Group A (n = 340) were ≤75 years old with <3 comorbidities. Group B (n = 163) were >75 years old with ≥3 comorbidities. Assessments occurred at baseline, first‐year (Y1) and third‐year (Y3) follow‐ups. The study used an explorative and descriptive approach. Group A: median age was 65 years, 70% were female, and 46% had no comorbidities at baseline. Baseline risk assessment yielded low (23%), intermediate (66%), and high risk (11%). Among patients at low, intermediate, or high risk at baseline, 51%, 18%, and 13%, respectively, were at low risk at Y3. At baseline, monotherapy was the most common therapy among low (68%) and intermediate groups (60%), while dual therapy was the most common among high risk (69%). In patients assessed as low, intermediate, or high risk at Y1, 66%, 12%, and 0% were at low risk at Y3, respectively. Of patients at intermediate or high risk at Y1, 35% received monotherapy and 13% received triple therapy. In low‐risk patients at Y1, monotherapy (40%) and dual therapy (43%) were evenly distributed. Group B: median age was 77 years, 50% were female, and 44% had ≥3 comorbidities at baseline. At baseline, 8% were at low, 80% at intermediate, and 12% at high risk. Monotherapy was the most common therapy (62%) in Group B at baseline. Few patients maintained or reached low risk at follow‐ups. CONCLUSIONS: Most patients with PAH did not meet low‐risk criteria during the 3 year follow‐up. The first year from diagnosis seems important in defining the longitudinal risk status. John Wiley and Sons Inc. 2020-12-10 /pmc/articles/PMC7835578/ /pubmed/33305545 http://dx.doi.org/10.1002/ehf2.13162 Text en © 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research Articles
Bouzina, Habib
Rådegran, Göran
Butler, Oisin
Hesselstrand, Roger
Hjalmarsson, Clara
Holl, Katsiaryna
Jansson, Kjell
Klok, Rogier
Söderberg, Stefan
Kjellström, Barbro
Longitudinal changes in risk status in pulmonary arterial hypertension
title Longitudinal changes in risk status in pulmonary arterial hypertension
title_full Longitudinal changes in risk status in pulmonary arterial hypertension
title_fullStr Longitudinal changes in risk status in pulmonary arterial hypertension
title_full_unstemmed Longitudinal changes in risk status in pulmonary arterial hypertension
title_short Longitudinal changes in risk status in pulmonary arterial hypertension
title_sort longitudinal changes in risk status in pulmonary arterial hypertension
topic Original Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835578/
https://www.ncbi.nlm.nih.gov/pubmed/33305545
http://dx.doi.org/10.1002/ehf2.13162
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