利奥西呱和球囊肺动脉血管成形术可改善无法手术的慢性血栓栓塞性肺动脉高压患者的预后。
Riociguat and balloon pulmonary angioplasty improve prognosis in patients with inoperable chronic thromboembolic pulmonary Hypertension.
作者信息
Wiedenroth Christoph B, Rolf Andreas, Steinhaus Kristin, Adameit Miriam S D, Kriechbaum Steffen D, Haas Moritz, Roller Fritz, Hamm Christian W, Ghofrani H Ardeschir, Mayer Eckhard, Breithecker Andreas, Guth Stefan, Liebetrau Christoph
机构信息
Kerckhoff Heart and Lung Center, Department of Thoracic Surgery, Bad Nauheim, Germany.
Kerckhoff Heart and Lung Center, Department of Cardiology, Bad Nauheim, Germany; German Center for Cardiovascular Research (DZHK), partner site RheinMain, Bad Nauheim, Germany.
出版信息
J Heart Lung Transplant. 2023 Jan;42(1):134-139. doi: 10.1016/j.healun.2022.08.011. Epub 2022 Aug 23.
BACKGROUND
The combination of riociguat and interventional balloon pulmonary angioplasty (BPA) is currently used to treat patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). The aim of the present study was to evaluate the impact of this combination therapy on the prognosis of inoperable CTEPH patients by comparing the long-term survival rates of patients undergoing combination therapy with riociguat and BPA with those of inoperable patients from the first international CTEPH registry who did not receive specific treatment.
METHODS
Between March 2014 and August 2019, 138 technically inoperable patients were included in the present prospective, observational cohort study when they were treated with riociguat and BPA at a single CTEPH referral center. Long-term survival of this cohort was compared using propensity score matching with that of inoperable patients recruited between 2007 and 2009 in the first international CTEPH registry. Kaplan-Meier methods were used to evaluate differences in outcomes.
RESULTS
Whereas the survival rate in the historical group was 84.6% in the first year, 76.6% in the second, 68.5% in the third, and 58.5% in the fifth year after diagnosis, implementation of riociguat/BPA led to survival rates of 100%, 96.7%, 92.9%, and 90% in the respective follow-up periods. In a comparison of 83 well-matched pairs from the 2 cohorts, survival was markedly better in the group treated with riociguat and BPA than in the historical cohort (HR = 0.145, 95% CI 0.05, 0.421).
CONCLUSION
The combination of riociguat and BPA for the treatment of inoperable CTEPH is associated with excellent 5-year survival rates.
背景
利奥西呱与介入性球囊肺动脉血管成形术（BPA）联合应用目前用于治疗无法手术的慢性血栓栓塞性肺动脉高压（CTEPH）患者。本研究的目的是通过比较接受利奥西呱与BPA联合治疗的患者与来自首个国际CTEPH注册研究中未接受特异性治疗的无法手术患者的长期生存率，评估这种联合治疗对无法手术的CTEPH患者预后的影响。
方法
2014年3月至2019年8月期间，138例技术上无法手术的患者在单一CTEPH转诊中心接受利奥西呱和BPA治疗时被纳入本前瞻性观察队列研究。使用倾向评分匹配法将该队列的长期生存率与2007年至2009年在首个国际CTEPH注册研究中招募的无法手术患者的生存率进行比较。采用Kaplan-Meier方法评估结局差异。
结果
历史组在诊断后第一年、第二年、第三年和第五年的生存率分别为84.6%、76.6%、68.5%和58.5%，而实施利奥西呱/BPA治疗后，各随访期的生存率分别为100%、96.7%、92.9%和90%。在对两个队列中83对匹配良好的病例进行比较时，接受利奥西呱和BPA治疗的组的生存率明显高于历史队列（HR = 0.145，95%CI 0.05，0.421）。
结论
利奥西呱与BPA联合治疗无法手术的CTEPH与优异的5年生存率相关。
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