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Longitudinal changes in risk status in pulmonary arterial hypertension
Habib Bouzina1, Göran Rådegran1, Oisin Butler2
1Department of Clinical Sciences Lund, Cardiology, Faculty of Medicine and Hemodynamic Lab, Section for Heart Failure and Valvular Disease, VO. Heart and Lung Medicine, Lund University, Skåne University Hospital, Lund, Sweden.
ESC Heart Failure
|December 11, 2020
Summary
Most pulmonary arterial hypertension (PAH) patients do not achieve low-risk status within three years. Early risk assessment and treatment adjustments in the first year are crucial for long-term outcomes in PAH management.
Area of Science:
- Cardiology
- Pulmonology
- Clinical Research
Background:
- Low-risk status in pulmonary arterial hypertension (PAH) is associated with improved patient survival.
- Understanding the evolution of risk status and treatment patterns over time is essential for optimizing PAH care.
- Age and comorbidity burden significantly influence patient prognosis and management strategies in PAH.
Purpose of the Study:
- To analyze changes in risk status among pulmonary arterial hypertension (PAH) patients over a three-year period.
- To investigate the impact of age and comorbidity on risk status evolution and treatment approaches in PAH.
- To identify critical time points for risk assessment and intervention in PAH management.
Main Methods:
- Retrospective analysis of incident PAH patients from the Swedish PAH registry (2008-2019).
- Patients were stratified into two groups based on age and comorbidity burden (Group A: ≤75 years/<3 comorbidities; Group B: >75 years/≥3 comorbidities).
- Risk status and treatment strategies were assessed at baseline, year 1 (Y1), and year 3 (Y3) follow-ups.
Main Results:
- A majority of PAH patients did not achieve low-risk status by Y3, with only 51% of initially low-risk patients remaining low-risk at Y3.
- In Group A, baseline risk distribution was low (23%), intermediate (66%), and high (11%). By Y3, low-risk status was maintained by 51% of baseline low-risk patients.
- In Group B, baseline risk was predominantly intermediate (80%), with few patients achieving low-risk status at follow-up. Treatment varied, with monotherapy common at baseline across risk groups.
Conclusions:
- Most pulmonary arterial hypertension (PAH) patients do not meet low-risk criteria within a three-year follow-up period.
- The first year post-diagnosis appears critical in determining the long-term risk trajectory for PAH patients.
- Age and comorbidity significantly impact risk status and treatment patterns, highlighting the need for personalized PAH management strategies.
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