Mortality in pulmonary arterial hypertension: prediction by the 2015 European pulmonary hypertension guidelines risk stratification model
The 2015 European pulmonary hypertension (PH) guidelines propose a risk stratification strategy for patients with pulmonary arterial hypertension (PAH). Low-, intermediate- and high-risk strata are defined by estimated 1-year mortality risks of <5%, 5–10% and >10%, respectively. This risk asse...
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| Published in | The European respiratory journal Vol. 50; no. 2; p. 1700740 |
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| Main Authors | , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
European Respiratory Society Journals Ltd
01.08.2017
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| Subjects | |
| Online Access | Get full text |
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| Abstract | The 2015 European pulmonary hypertension (PH) guidelines propose a risk stratification strategy for patients with pulmonary arterial hypertension (PAH). Low-, intermediate- and high-risk strata are defined by estimated 1-year mortality risks of <5%, 5–10% and >10%, respectively. This risk assessment strategy awaits validation.
We analysed data from patients with newly diagnosed PAH enrolled into COMPERA (Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension), a European-based PH registry. An abbreviated version of the risk assessment strategy proposed by the European PH guidelines was applied, using the following variables: World Health Organization functional class, 6-min walking distance, brain natriuretic peptide or its N-terminal fragment, right atrial pressure, cardiac index and mixed venous oxygen saturation.
Data from 1588 patients were analysed. Mortality rates were significantly different between the three risk strata (p<0.001 for all comparisons). In the entire patient population, the observed mortality rates 1 year after diagnosis were 2.8% in the low-risk cohort (n=196), 9.9% in the intermediate-risk cohort (n=1116) and 21.2% in the high-risk cohort (n=276). In addition, the risk assessment strategy proved valid at follow-up and in major PAH subgroups.
An abbreviated version of the risk assessment strategy proposed by the current European PH guidelines provides accurate mortality estimates in patients with PAH. |
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| AbstractList | The 2015 European pulmonary hypertension (PH) guidelines propose a risk stratification strategy for patients with pulmonary arterial hypertension (PAH). Low-, intermediate- and high-risk strata are defined by estimated 1-year mortality risks of <5%, 5-10% and >10%, respectively. This risk assessment strategy awaits validation.We analysed data from patients with newly diagnosed PAH enrolled into COMPERA (Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension), a European-based PH registry. An abbreviated version of the risk assessment strategy proposed by the European PH guidelines was applied, using the following variables: World Health Organization functional class, 6-min walking distance, brain natriuretic peptide or its N-terminal fragment, right atrial pressure, cardiac index and mixed venous oxygen saturation.Data from 1588 patients were analysed. Mortality rates were significantly different between the three risk strata (p<0.001 for all comparisons). In the entire patient population, the observed mortality rates 1 year after diagnosis were 2.8% in the low-risk cohort (n=196), 9.9% in the intermediate-risk cohort (n=1116) and 21.2% in the high-risk cohort (n=276). In addition, the risk assessment strategy proved valid at follow-up and in major PAH subgroups.An abbreviated version of the risk assessment strategy proposed by the current European PH guidelines provides accurate mortality estimates in patients with PAH.The 2015 European pulmonary hypertension (PH) guidelines propose a risk stratification strategy for patients with pulmonary arterial hypertension (PAH). Low-, intermediate- and high-risk strata are defined by estimated 1-year mortality risks of <5%, 5-10% and >10%, respectively. This risk assessment strategy awaits validation.We analysed data from patients with newly diagnosed PAH enrolled into COMPERA (Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension), a European-based PH registry. An abbreviated version of the risk assessment strategy proposed by the European PH guidelines was applied, using the following variables: World Health Organization functional class, 6-min walking distance, brain natriuretic peptide or its N-terminal fragment, right atrial pressure, cardiac index and mixed venous oxygen saturation.Data from 1588 patients were analysed. Mortality rates were significantly different between the three risk strata (p<0.001 for all comparisons). In the entire patient population, the observed mortality rates 1 year after diagnosis were 2.8% in the low-risk cohort (n=196), 9.9% in the intermediate-risk cohort (n=1116) and 21.2% in the high-risk cohort (n=276). In addition, the risk assessment strategy proved valid at follow-up and in major PAH subgroups.An abbreviated version of the risk assessment strategy proposed by the current European PH guidelines provides accurate mortality estimates in patients with PAH. The 2015 European pulmonary hypertension (PH) guidelines propose a risk stratification strategy for patients with pulmonary arterial hypertension (PAH). Low-, intermediate- and high-risk strata are defined by estimated 1-year mortality risks of <5%, 5–10% and >10%, respectively. This risk assessment strategy awaits validation.We analysed data from patients with newly diagnosed PAH enrolled into COMPERA (Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension), a European-based PH registry. An abbreviated version of the risk assessment strategy proposed by the European PH guidelines was applied, using the following variables: World Health Organization functional class, 6-min walking distance, brain natriuretic peptide or its N-terminal fragment, right atrial pressure, cardiac index and mixed venous oxygen saturation.Data from 1588 patients were analysed. Mortality rates were significantly different between the three risk strata (p<0.001 for all comparisons). In the entire patient population, the observed mortality rates 1 year after diagnosis were 2.8% in the low-risk cohort (n=196), 9.9% in the intermediate-risk cohort (n=1116) and 21.2% in the high-risk cohort (n=276). In addition, the risk assessment strategy proved valid at follow-up and in major PAH subgroups.An abbreviated version of the risk assessment strategy proposed by the current European PH guidelines provides accurate mortality estimates in patients with PAH. The 2015 European pulmonary hypertension (PH) guidelines propose a risk stratification strategy for patients with pulmonary arterial hypertension (PAH). Low-, intermediate- and high-risk strata are defined by estimated 1-year mortality risks of <5%, 5–10% and >10%, respectively. This risk assessment strategy awaits validation. We analysed data from patients with newly diagnosed PAH enrolled into COMPERA (Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension), a European-based PH registry. An abbreviated version of the risk assessment strategy proposed by the European PH guidelines was applied, using the following variables: World Health Organization functional class, 6-min walking distance, brain natriuretic peptide or its N-terminal fragment, right atrial pressure, cardiac index and mixed venous oxygen saturation. Data from 1588 patients were analysed. Mortality rates were significantly different between the three risk strata (p<0.001 for all comparisons). In the entire patient population, the observed mortality rates 1 year after diagnosis were 2.8% in the low-risk cohort (n=196), 9.9% in the intermediate-risk cohort (n=1116) and 21.2% in the high-risk cohort (n=276). In addition, the risk assessment strategy proved valid at follow-up and in major PAH subgroups. An abbreviated version of the risk assessment strategy proposed by the current European PH guidelines provides accurate mortality estimates in patients with PAH. |
| Author | Grünig, Ekkehard Ghofrani, H. Ardeschir Eichstaedt, Christina A. Olsson, Karen M. Pan, Zixuan Spiesshoefer, Jens Distler, Oliver Opitz, Christian Vonk-Noordegraaf, Anton Hoeper, Marius M. Pittrow, David Gibbs, J. Simon R. Delcroix, Marion Vizza, Carmine Dario Meyer, Katrin Rosenkranz, Stephan Benjamin, Nicola Huscher, Doerte Kramer, Tilmann |
| Author_xml | – sequence: 1 givenname: Marius M. surname: Hoeper fullname: Hoeper, Marius M. – sequence: 2 givenname: Tilmann surname: Kramer fullname: Kramer, Tilmann – sequence: 3 givenname: Zixuan surname: Pan fullname: Pan, Zixuan – sequence: 4 givenname: Christina A. surname: Eichstaedt fullname: Eichstaedt, Christina A. – sequence: 5 givenname: Jens surname: Spiesshoefer fullname: Spiesshoefer, Jens – sequence: 6 givenname: Nicola surname: Benjamin fullname: Benjamin, Nicola – sequence: 7 givenname: Karen M. surname: Olsson fullname: Olsson, Karen M. – sequence: 8 givenname: Katrin surname: Meyer fullname: Meyer, Katrin – sequence: 9 givenname: Carmine Dario orcidid: 0000-0002-3540-4983 surname: Vizza fullname: Vizza, Carmine Dario – sequence: 10 givenname: Anton surname: Vonk-Noordegraaf fullname: Vonk-Noordegraaf, Anton – sequence: 11 givenname: Oliver surname: Distler fullname: Distler, Oliver – sequence: 12 givenname: Christian surname: Opitz fullname: Opitz, Christian – sequence: 13 givenname: J. Simon R. surname: Gibbs fullname: Gibbs, J. Simon R. – sequence: 14 givenname: Marion surname: Delcroix fullname: Delcroix, Marion – sequence: 15 givenname: H. Ardeschir surname: Ghofrani fullname: Ghofrani, H. Ardeschir – sequence: 16 givenname: Doerte surname: Huscher fullname: Huscher, Doerte – sequence: 17 givenname: David surname: Pittrow fullname: Pittrow, David – sequence: 18 givenname: Stephan surname: Rosenkranz fullname: Rosenkranz, Stephan – sequence: 19 givenname: Ekkehard surname: Grünig fullname: Grünig, Ekkehard |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28775047$$D View this record in MEDLINE/PubMed |
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