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西班牙裔肺动脉高压患者群体的预后:常见风险分层模型的应用

Prognosis in Hispanic patient population with pulmonary arterial hypertension: An application of common risk stratification models.

作者信息

Fadah Kahtan, Cruz Rodriguez Jose B, Alkhateeb Haider, Mukherjee Debabrata, Garcia Hernando, Schuller Dan, Mohammad Khan O, Sahay Sandeep, Nickel Nils P

机构信息

Department of Internal Medicine Texas Tech University Health Sciences Center El Paso El Paso Texas USA.

Department of Internal Medicine, Division of Cardiovascular Medicine University of California San Diego San Diego California USA.

出版信息

Pulm Circ. 2023 Apr 1;13(2):e12209. doi: 10.1002/pul2.12209. eCollection 2023 Apr.

Abstract

Pulmonary arterial hypertension (PAH) is a cardiovascular disease with high mortality rate. Current guidelines propose initiation and escalation of PAH-targeted treatment based on a goal-directed approach targeting hemodynamic, functional, and biochemical variables. This approach has been successfully validated in large Caucasian cohorts. However, given the low number of Hispanic patients enrolled in large PAH trials and registries, it is unknown if the same prognostic tools can be applied to this patient population. We analyzed a single-center outpatient cohort that consisted of 135 Hispanic patients diagnosed with PAH. Baseline characteristics were calculated based on COMPERA, COMPERA 2.0 and REVEAL 2.0 risk scores before the initiation of PAH-targeted therapies. The survival rate at 1 year after diagnosis was 88% for the entire cohort. The three established risk scores to predict PAH outcomes yielded similar results with reasonable discrimination of mortality in the different risk strata (all  < 0.001). Hispanic patients with PAH have a high mortality rate. Our analysis suggests that guideline proposed risk assessment at baseline yields important prognostic information in this patient population.

摘要

肺动脉高压(PAH)是一种死亡率很高的心血管疾病。当前指南建议基于针对血流动力学、功能和生化变量的目标导向方法启动并加强PAH靶向治疗。这种方法已在大型白种人队列中得到成功验证。然而,鉴于参与大型PAH试验和登记的西班牙裔患者数量较少,尚不清楚相同的预后工具是否可应用于该患者群体。我们分析了一个单中心门诊队列,该队列由135名被诊断为PAH的西班牙裔患者组成。在开始PAH靶向治疗之前,根据COMPERA、COMPERA 2.0和REVEAL 2.0风险评分计算基线特征。整个队列诊断后1年的生存率为88%。用于预测PAH结局的三个既定风险评分产生了相似的结果,在不同风险分层中对死亡率有合理的区分度(均<0.001)。患有PAH的西班牙裔患者死亡率很高。我们的分析表明,指南建议的基线风险评估在该患者群体中产生了重要的预后信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc9a/10069240/5a945ce58211/PUL2-13-e12209-g002.jpg

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