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Pulmonary Hypertension Registry of Kerala, India (PRO-KERALA): One-year outcomes
BACKGROUND: Short term outcomes of patients with pulmonary hypertension are not available from low and middle-income countries including India. METHODS: We conducted a prospective study of 2003 patients with pulmonary hypertension, from 50 centres (PROKERALA) in Kerala, who were followed up for one...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8891004/ https://www.ncbi.nlm.nih.gov/pubmed/34919965 http://dx.doi.org/10.1016/j.ihj.2021.12.002 |
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author | Harikrishnan, S. Mani, Avinash G, Sanjay M, Ashishkumar Menon, Jaideep G, Rajesh Kumar, R. Krishna Koshy, A. George Attacheril, Thankachan V. George, Raju Punnose, Eapen Ashraf, S.M. SR, Arun Cholakkal, Mohammed Jeemon, Panniyammakal Joseph, Stigi Govindan, Unni Joseph, Johny Eapen, Koshy Sreedharan, Madhu Kumar, Anil Venugopal, K. |
author_facet | Harikrishnan, S. Mani, Avinash G, Sanjay M, Ashishkumar Menon, Jaideep G, Rajesh Kumar, R. Krishna Koshy, A. George Attacheril, Thankachan V. George, Raju Punnose, Eapen Ashraf, S.M. SR, Arun Cholakkal, Mohammed Jeemon, Panniyammakal Joseph, Stigi Govindan, Unni Joseph, Johny Eapen, Koshy Sreedharan, Madhu Kumar, Anil Venugopal, K. |
author_sort | Harikrishnan, S. |
collection | PubMed |
description | BACKGROUND: Short term outcomes of patients with pulmonary hypertension are not available from low and middle-income countries including India. METHODS: We conducted a prospective study of 2003 patients with pulmonary hypertension, from 50 centres (PROKERALA) in Kerala, who were followed up for one year. Pulmonary hypertension (PH) was mainly diagnosed on the basis of Doppler echocardiography. The primary outcome was a composite end-point of all-cause death and hospital admission for heart failure. All cause hospitalisation events constituted the secondary outcome. RESULTS: Mean age of study population was 56 ± 16 years. Group 1 and Group 2 PH categories constituted 21.2% and 59% of the study population, respectively. Nearly two-thirds (65%) of the study participants had functional class II symptoms. 31% of Group 1 PH patients were on specific vasodilator drugs.In total, 83 patients (4.1%) died during the one-year follow-up period. Further, 1235 re-hospitalisation events (61.7%) were reported. In the multivariate model, baseline NYHA class III/IV (OR 1.87, 95% C.I. 1.35–2.56), use of calcium channel blockers (OR 0.18, 95% C.I. 0.04–0.77), vasodilator therapy (OR 0.5, 95% C.I. 0.28–0.87) and antiplatelet agents (OR 1.80, 95% C.I. 1.29–2.51) were associated with primary composite outcome at one-year (p < 0.05). CONCLUSION: In the PROKERALA registry, annual mortality rate was 4%. More than half of the patients reported re-hospitalisation events on follow up. Uptake of guideline directed therapies were suboptimal in the study population. Quality improvement programmes to improve guideline directed therapy may improve clinical outcomes of PH patients in India. |
format | Online Article Text |
id | pubmed-8891004 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-88910042022-03-04 Pulmonary Hypertension Registry of Kerala, India (PRO-KERALA): One-year outcomes Harikrishnan, S. Mani, Avinash G, Sanjay M, Ashishkumar Menon, Jaideep G, Rajesh Kumar, R. Krishna Koshy, A. George Attacheril, Thankachan V. George, Raju Punnose, Eapen Ashraf, S.M. SR, Arun Cholakkal, Mohammed Jeemon, Panniyammakal Joseph, Stigi Govindan, Unni Joseph, Johny Eapen, Koshy Sreedharan, Madhu Kumar, Anil Venugopal, K. Indian Heart J Original Article BACKGROUND: Short term outcomes of patients with pulmonary hypertension are not available from low and middle-income countries including India. METHODS: We conducted a prospective study of 2003 patients with pulmonary hypertension, from 50 centres (PROKERALA) in Kerala, who were followed up for one year. Pulmonary hypertension (PH) was mainly diagnosed on the basis of Doppler echocardiography. The primary outcome was a composite end-point of all-cause death and hospital admission for heart failure. All cause hospitalisation events constituted the secondary outcome. RESULTS: Mean age of study population was 56 ± 16 years. Group 1 and Group 2 PH categories constituted 21.2% and 59% of the study population, respectively. Nearly two-thirds (65%) of the study participants had functional class II symptoms. 31% of Group 1 PH patients were on specific vasodilator drugs.In total, 83 patients (4.1%) died during the one-year follow-up period. Further, 1235 re-hospitalisation events (61.7%) were reported. In the multivariate model, baseline NYHA class III/IV (OR 1.87, 95% C.I. 1.35–2.56), use of calcium channel blockers (OR 0.18, 95% C.I. 0.04–0.77), vasodilator therapy (OR 0.5, 95% C.I. 0.28–0.87) and antiplatelet agents (OR 1.80, 95% C.I. 1.29–2.51) were associated with primary composite outcome at one-year (p < 0.05). CONCLUSION: In the PROKERALA registry, annual mortality rate was 4%. More than half of the patients reported re-hospitalisation events on follow up. Uptake of guideline directed therapies were suboptimal in the study population. Quality improvement programmes to improve guideline directed therapy may improve clinical outcomes of PH patients in India. Elsevier 2022 2021-12-14 /pmc/articles/PMC8891004/ /pubmed/34919965 http://dx.doi.org/10.1016/j.ihj.2021.12.002 Text en © 2021 Cardiological Society of India. Published by Elsevier B.V. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Harikrishnan, S. Mani, Avinash G, Sanjay M, Ashishkumar Menon, Jaideep G, Rajesh Kumar, R. Krishna Koshy, A. George Attacheril, Thankachan V. George, Raju Punnose, Eapen Ashraf, S.M. SR, Arun Cholakkal, Mohammed Jeemon, Panniyammakal Joseph, Stigi Govindan, Unni Joseph, Johny Eapen, Koshy Sreedharan, Madhu Kumar, Anil Venugopal, K. Pulmonary Hypertension Registry of Kerala, India (PRO-KERALA): One-year outcomes |
title | Pulmonary Hypertension Registry of Kerala, India (PRO-KERALA): One-year outcomes |
title_full | Pulmonary Hypertension Registry of Kerala, India (PRO-KERALA): One-year outcomes |
title_fullStr | Pulmonary Hypertension Registry of Kerala, India (PRO-KERALA): One-year outcomes |
title_full_unstemmed | Pulmonary Hypertension Registry of Kerala, India (PRO-KERALA): One-year outcomes |
title_short | Pulmonary Hypertension Registry of Kerala, India (PRO-KERALA): One-year outcomes |
title_sort | pulmonary hypertension registry of kerala, india (pro-kerala): one-year outcomes |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8891004/ https://www.ncbi.nlm.nih.gov/pubmed/34919965 http://dx.doi.org/10.1016/j.ihj.2021.12.002 |
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