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阿根廷肺动脉高压协作登记处(RECOPILAR)。最终分析。

Collaborative registry of pulmonary hypertension in Argentina (RECOPILAR). Final analysis.

作者信息

Echazarreta Diego F, Perna Eduardo R, Coronel María L, Diez Mirta, Lescano Adrián J, Atamañuk Andrés N, Mazzei Juan A, Cáneva Jorge O, Svelitza Graciela N, Nitsche Alejandro, Babini Alejandra, Casado Gustavo, Haag Dora F, Cazalas Mariana, Stepffer Carolina

机构信息

Federación Argentina de Cardiología (FAC), Argentina.

Sociedad Argentina de Cardiología (SAC), Argentina.

出版信息

Medicina (B Aires). 2021;81(2):180-190.

Abstract

The epidemiology of pulmonary hypertension (PH), especially pulmonary arterial hypertension (PAH), has not been evaluated in our country, therefore there is no reference parameter to establishing the representativeness of this information in the national order. This registry represents the first collaborative effort to provide a knowledge base of this disease, including 5 scientific societies that represent different specialties (pediatrics, rheumatology, pulmonology and cardiology) with data from 23 Argentine provinces. These efforts involved five societies of various adult (cardiology, rheumatology, and pulmonology) and pediatric (cardiology) specialties. Subjects were grouped (1-5) in accord with the 2013 Nice classification. A total of 627 patients (mean age, 50.8 ± 18 years; women, 69.2%) were recruited. Incident cases accounted for 53%. Functional class III-IV accounted for 69% at time of diagnosis and 33.4% at time of inclusion. Distributions in groups 1-5 were 63.6%, 15.9%, 8.3%, 9.7%, and 2.4%, respectively. Treatment consisted of diuretics (51.2%), mineralocorticoid receptor antagonists (44.7%), digoxin (16.6%), anticoagulants (39.2%), renin-angiotensin antagonists (15.5%), beta blockers (15.6%), and calcium channel blockers (8%). Rates of specific therapies usage in PAH vs. non-PAH group were 80.5% vs. 40.8% (phosphodiesterase-5 inhibitors: 71% vs. 38.6%; endothelin receptor antagonists: 54.4% vs. 14.5%; prostanoids: 14.3 vs. 3.1%; all p < 0.001). Three-year survival in PAH and non-PAH differed significantly (82.8% vs. 73.3%; p = 0.001). In the Argentine RECOPILAR registry, the clinic-epidemiologic profile was that of advanced-stage disease. Diagnostic workups and therapeutics interventions, including use of specific therapy for PAH, were consistent with current recommendations. Despite delays in diagnosis, survival was aligned with other contemporary registries.

摘要

我国尚未对肺动脉高压(PH),尤其是动脉性肺动脉高压(PAH)的流行病学情况进行评估,因此缺乏参考参数来确定该疾病在我国的代表性情况。本登记系统是为提供该疾病知识库所做的首次合作努力,参与的有代表不同专业(儿科、风湿病学、肺病学和心脏病学)的5个科学学会,数据来自阿根廷的23个省份。这些努力涉及5个不同专业学会,包括成人专业(心脏病学、风湿病学和肺病学)和儿科专业(心脏病学)。根据2013年尼斯分类标准,将研究对象分为1 - 5组。共招募了627例患者(平均年龄50.8±18岁;女性占69.2%)。新发病例占53%。诊断时功能分级III - IV级的患者占69%,纳入研究时占33.4%。1 - 5组的分布分别为63.6%、15.9%、8.3%、9.7%和2.4%。治疗药物包括利尿剂(51.2%)、盐皮质激素受体拮抗剂(44.7%)、地高辛(16.6%)、抗凝剂(39.2%)、肾素 - 血管紧张素拮抗剂(15.5%)、β受体阻滞剂(15.6%)和钙通道阻滞剂(8%)。PAH组与非PAH组的特定治疗药物使用率分别为80.5%和40.8%(磷酸二酯酶 - 5抑制剂:71%和38.6%;内皮素受体拮抗剂:54.4%和14.5%;前列环素:14.3%和3.1%;所有p < 0.001)。PAH组和非PAH组的3年生存率有显著差异(82.8%对73.3%;p = 0.001)。在阿根廷RECOPILAR登记系统中,临床 - 流行病学特征显示为疾病晚期。诊断检查和治疗干预,包括PAH的特异性治疗药物使用,均符合当前推荐标准。尽管存在诊断延迟,但生存率与其他当代登记系统一致。

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