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N A Tsareva1, S N Avdeev

  • 1Sechenov First Moscow State Medical University (Sechenov University); Research Institute of Pulmonology. n_tsareva@mail.ru.

Kardiologiia
|January 10, 2019
PubMed
Summary

This review covers advanced pulmonary hypertension treatments for patients unresponsive to initial therapies. It details risk stratification and switching strategies for more effective pulmonary arterial hypertension (PAH) management.

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Area of Science:

  • Cardiology
  • Pulmonology
  • Pharmacology

Background:

  • Pulmonary hypertension (PH) requires effective therapeutic strategies.
  • Many patients do not achieve satisfactory clinical response with initial treatments.
  • Optimizing therapy is crucial for improving patient outcomes.

Purpose of the Study:

  • To review modern therapeutic tactics for pulmonary hypertension.
  • To present current risk stratification methods for annual mortality.
  • To discuss treatment adjustments and drug class switching.

Main Methods:

  • Review of pathogenetic therapy classes for PH.
  • Analysis of risk stratification models for PH patients.
  • Discussion of treatment escalation and switching strategies.
  • Inclusion of the latest PH classification (Nice, 2018).

Main Results:

  • Comprehensive overview of all pathogenetic therapy classes for PH.
  • Updated insights into risk stratification for predicting annual mortality.
  • Guidance on switching to more effective drugs within or between therapy classes.
  • Presentation of the Nice 2018 classification of PH.

Conclusions:

  • Effective management of pulmonary hypertension involves tailored, stepwise therapeutic adjustments.
  • Risk stratification is essential for guiding treatment decisions and improving survival.
  • Switching to advanced or alternative drug classes can enhance clinical response in non-responders.

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