Document Detail


Survival in patients with idiopathic, familial, and anorexigen-associated pulmonary arterial hypertension in the modern management era.
MedLine Citation:
PMID:  20585011     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Novel therapies have recently become available for pulmonary arterial hypertension. We conducted a study to characterize mortality in a multicenter prospective cohort of patients diagnosed with idiopathic, familial, or anorexigen-associated pulmonary arterial hypertension in the modern management era. METHODS AND RESULTS: Between October 2002 and October 2003, 354 consecutive adult patients with idiopathic, familial, or anorexigen-associated pulmonary arterial hypertension (56 incident and 298 prevalent cases) were prospectively enrolled. Patients were followed up for 3 years, and survival rates were analyzed. For incident cases, estimated survival (95% confidence intervals [CIs]) at 1, 2, and 3 years was 85.7% (95% CI, 76.5 to 94.9), 69.6% (95% CI, 57.6 to 81.6), and 54.9% (95% CI, 41.8 to 68.0), respectively. In a combined analysis population (incident patients and prevalent patients diagnosed within 3 years before study entry; n=190), 1-, 2-, and 3-year survival estimates were 82.9% (95% CI, 72.4 to 95.0), 67.1% (95% CI, 57.1 to 78.8), and 58.2% (95% CI, 49.0 to 69.3), respectively. Individual survival analysis identified the following as significantly and positively associated with survival: female gender, New York Heart Association functional class I/II, greater 6-minute walk distance, lower right atrial pressure, and higher cardiac output. Multivariable analysis showed that being female, having a greater 6-minute walk distance, and exhibiting higher cardiac output were jointly significantly associated with improved survival. CONCLUSIONS: In the modern management era, idiopathic, familial, and anorexigen-associated pulmonary arterial hypertension remains a progressive, fatal disease. Mortality is most closely associated with male gender, right ventricular hemodynamic function, and exercise limitation.
Authors:
Marc Humbert; Olivier Sitbon; Ari Chaouat; Michèle Bertocchi; Gilbert Habib; Virginie Gressin; Azzedine Yaïci; Emmanuel Weitzenblum; Jean-François Cordier; François Chabot; Claire Dromer; Christophe Pison; Martine Reynaud-Gaubert; Alain Haloun; Marcel Laurent; Eric Hachulla; Vincent Cottin; Bruno Degano; Xavier Jaïs; David Montani; Rogério Souza; Gérald Simonneau
Publication Detail:
Type:  Clinical Trial; In Vitro; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-06-28
Journal Detail:
Title:  Circulation     Volume:  122     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-13     Completed Date:  2010-07-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  156-63     Citation Subset:  AIM; IM    
Affiliation:
Service de Pneumologie et Réanimation Respiratoire, Faculté de Médecine, Hôpital Antoine Béclère, Assistance-Publique-Hôpitaux de Paris, Université Paris-Sud 11, 92140 Clamart, France. marc.humbert@abc.aphp.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiac Output
Female
Follow-Up Studies
Genetic Diseases, Inborn / drug therapy,  mortality*,  physiopathology
Humans
Hypertension, Pulmonary / drug therapy,  mortality*,  physiopathology
Incidence
Male
Middle Aged
Prevalence
Prospective Studies
Sex Factors
Survival Rate
Comments/Corrections
Comment In:
Circulation. 2010 Jul 13;122(2):106-8   [PMID:  20585007 ]

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


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