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Establishing a Competing Risk Regression Nomogram Model for Survival Data
04:57

Establishing a Competing Risk Regression Nomogram Model for Survival Data

Published on: October 23, 2020

10.7K

Risk stratification in chronic thromboembolic pulmonary hypertension predicts survival

Anna Sandqvist1,2, David Kylhammar3, Sven-Erik Bartfay4,5

  • 1Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden.

Scandinavian Cardiovascular Journal : SCJ
|June 27, 2020
PubMed

Insights

The European Society of Cardiology/European Respiratory Society (ESC/ERS) risk tool accurately predicts survival in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Pulmonary endarterectomy (PEA) significantly improves survival, regardless of the patient

Area of Science:

  • Cardiology
  • Pulmonology
  • Medical Guidelines

Background:

  • Pulmonary arterial hypertension (PAH) risk assessment tools guide treatment decisions.
  • The validity of the 2015 ESC/ERS PAH risk tool for chronic thromboembolic pulmonary hypertension (CTEPH) is not well-established.
  • Pulmonary endarterectomy (PEA) is a key treatment for CTEPH, influencing prognosis.

Purpose of the Study:

  • To evaluate the accuracy of the 2015 ESC/ERS PAH risk assessment tool in predicting survival for CTEPH patients.
  • To determine the impact of pulmonary endarterectomy (PEA) on survival within the CTEPH risk stratification framework.

Main Methods:

  • Analysis of incident CTEPH patients from the Swedish PAH Registry (SPAHR) (2008-2016).
  • Application of the ESC/ERS risk stratification algorithm at baseline and follow-up.
  • Multivariable analysis to assess mortality risk associated with risk profiles and PEA, adjusting for covariates.

Main Results:

  • The ESC/ERS risk tool identified CTEPH patients with significantly increased mortality risk in intermediate and high-risk groups compared to low-risk.
  • Pulmonary endarterectomy (PEA) was associated with markedly improved survival in CTEPH patients.
  • The prognostic value of the risk tool and the survival benefit of PEA were consistent at baseline and follow-up.

Conclusions:

  • The ESC/ERS risk assessment tool is a valid predictor of survival in CTEPH patients.
  • Pulmonary endarterectomy (PEA) offers a substantial survival advantage in CTEPH, independent of the patient's risk category or age.
Abstract

Keywords:
CTEPHgoal-oriented treatmentpulmonary endarterectomyrisk stratificationsurvival

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