Document Detail

Prediction of pulmonary hypertension related to systemic sclerosis by an index based on simple clinical observations.
MedLine Citation:
PMID:  21547892     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To develop a score to estimate the risk of developing pulmonary hypertension (PH) in patients with systemic sclerosis (SSc).
METHODS: We first examined the prevalence and characteristics of precapillary PH confirmed by right-heart catheterization in a cross-sectional (derivation) sample of 1,165 SSc patients, and we developed a risk prediction score (RPS) based on simple clinical observations associated with PH. We next prospectively tested the 3-year predictive power of the "Cochin RPS" in a separate (validation) sample of 443 patients presenting with PH-free SSc at baseline.
RESULTS: In the derivation sample, age, forced vital capacity, and diffusing capacity for carbon monoxide/alveolar volume were independently associated with the presence of PH and were used to create the Cochin RPS. PH developed during followup in 20 patients in the validation sample. The area under the receiver operating characteristic curve of the Cochin RPS was 0.87 (95% confidence interval 0.79-0.95). With a cutoff value of 2.73, patients at risk of PH during followup could be identified with 89.5% sensitivity and 74.1% specificity. PH occurred in 0.6% of patients in the lowest 2 quintiles of the Cochin RPS, in 1.7% of patients in the third and fourth quintiles, and in 17.1% of patients in the highest quintile (P<0.0001 by log rank test). Patients in the highest quintile incurred a >35-fold higher risk of developing PH compared with patients in the 2 lowest quintiles (P=0.001).
CONCLUSION: Using routine clinical observations, we developed a simple score that accurately predicted the risk of PH in SSc.
Christophe Meune; Jérôme Avouac; Paolo Airò; Lorenzo Beretta; Philippe Dieudé; Karim Wahbi; Paola Caramaschi; Kiet Tiev; Susanna Cappelli; Elisabeth Diot; Alessandra Vacca; Jean-Luc Cracowski; Jean Sibilia; André Kahan; Marco Matucci-Cerinic; Yannick Allanore
Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  63     ISSN:  1529-0131     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-07     Completed Date:  2011-11-08     Revised Date:  2012-07-24    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2790-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 by the American College of Rheumatology.
Paris Descartes University and Department of Rheumatology A, Cochin Hospital, AP-HP, Paris, France.
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MeSH Terms
Cross-Sectional Studies
Hypertension, Pulmonary / complications*,  epidemiology,  physiopathology
Middle Aged
Predictive Value of Tests
Prospective Studies
Scleroderma, Systemic / complications*,  physiopathology
Comment In:
Arthritis Rheum. 2012 Jun;64(6):2051-2   [PMID:  22294315 ]
Erratum In:
Arthritis Rheum. 2011 Dec;63(12):4030

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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