Impact of diabetes mellitus on disease severity and patient survival in idiopathic pulmonary arterial hypertension: data from the Polish multicentre registry (BNP-PL)

• Published in: Cardiovascular diabetology Vol. 22; no. 1; pp. 177 - 9
• Main Authors: Jonas, Kamil, Kurzyna, Marcin, Mroczek, Ewa, Chrzanowski, Łukasz, Mularek-Kubzdela, Tatiana, Skoczylas, Ilona, Błaszczak, Piotr, Grześk, Grzegorz, Mizia-Stec, Katarzyna, Kuśmierczyk, Beata, Kamiński, Karol, Lewicka, Ewa, Peregud-Pogorzelska, Małgorzata, Tomaszewski, Michał, Jacheć, Wojciech, Gąsior, Zbigniew, Pawlak, Agnieszka, Ryczek, Robert, Pruszczyk, Piotr, Doboszyńska, Anna, Widejko-Pietkiewicz, Katarzyna, Zabłocka, Wiesława, Waligóra, Marcin, Kopeć, Grzegorz
• Format: Journal Article
• Language: English
• Published: England BioMed Central 13.07.2023; BMC
• Subjects: Adult; Aspirin; Body mass index; Brain natriuretic peptide; Cardiac catheterization; Cardiovascular disease; Chi-square test; Comorbidity; Coronary vessels; Diabetes; Diabetes mellitus; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Diuretics; Dyspnea; Familial Primary Pulmonary Hypertension - diagnosis; Glucose; Glucose metabolism; Heart failure; Hemodynamics; Humans; Hypertension; Hypertension, Pulmonary - complications; Hypertension, Pulmonary - diagnosis; Hypertension, Pulmonary - epidemiology; Insulin; Intubation; Kidney diseases; Lipid metabolism; Lung diseases; Medical prognosis; Mortality; Patient Acuity; Patients; Poland - epidemiology; Prognosis; Prospective Studies; Pulmonary arterial hypertension; Pulmonary arteries; Pulmonary artery; Pulmonary hypertension; Registries; Respiration; Software; Statistical analysis; Survival; Survival analysis; Vascular diseases; Vein & artery diseases; Poland; Glucose metabolism; Pulmonary arterial hypertension; Diabetes; Mortality
• ISSN: 1475-2840; 1475-2840
• DOI: 10.1186/s12933-023-01885-6

Recent studies revealed that alterations in glucose and lipid metabolism in idiopathic pulmonary arterial hypertension (IPAH) are associated with disease severity and poor survival. However, data regarding the impact of diabetes mellitus (DM) on the prognosis of patients with IPAH remain scarce. The aim of our study was to determine that impact using data from a national multicentre prospective pulmonary hypertension registry. We analysed data of adult patients with IPAH from the Database of Pulmonary Hypertension in the Polish population (BNP‑PL) between March 1, 2018 and August 31, 2020. Upon admission, clinical, echocardiographic, and haemodynamic data were collected at 21 Polish IPAH reference centres. The all-cause mortality was assessed during a 30-month follow-up period. To adjust for differences in age, body mass index (BMI), and comorbidities between patients with and without DM, a 2-group propensity score matching was performed using a 1:1 pairing algorithm. A total of 532 patients with IPAH were included in the study and 25.6% were diagnosed with DM. Further matched analysis was performed in 136 patients with DM and 136 without DM. DM was associated with older age, higher BMI, more advanced exertional dyspnea, increased levels of N-terminal pro-brain natriuretic peptide, larger right atrial area, increased mean right atrial pressure, mean pulmonary artery pressure, pulmonary vascular resistance, and all-cause mortality compared with no DM. Patients with IPAH and DM present with more advanced pulmonary vascular disease and worse survival than counterparts without DM independently of age, BMI, and cardiovascular comorbidities.