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Comparison of baseline characteristics and survival between patients with idiopathic and connective tissue disease-related pulmonary arterial hypertension [artículo]

Por: Ruiz Cano, María José [Cardiología] | Escribano Subías, Pilar [Cardiología] | Alonso Fernández, Rafael Alberto [Hematología] | Delgado Jiménez, Juan Francisco [Cardiología] | Carreira Delgado, Patricia Esmeralda [Reumatología] | Velázquez Martín, María Teresa [Cardiología] | Gómez Sánchez, Miguel Ángel [Cardiología] | Sáenz de la Calzada Campo, Carlos [Cardiología].
Colaborador(es): Servicio de Cardiología | Servicio de Reumatología | Servicio de Hematología y Hemoterapia.
Editor: Journal of Heart and Lung Transplantation, 2009Descripción: 28(6):621-627.Recursos en línea: Solicitar documento Resumen: Background: Both idiopathic pulmonary arterial hypertension (IPAH) and pulmonary arterial hypertension (PAH) related to connective tissue diseases (CPAH) are classified in the group of PAH disorders. However, CPAH has a particularly worse prognosis than IPAH. Few studies have compared the clinical, functional and hemodynamic profiles of IPAH and CPAH. Methods: We performed a retrospective cohort stud), of patients with IPAH or CPAH. Demographic characteristics, functional status (FE), pulmonary), function test and hemodynamic values at the time of diagnosis were compared between the two etiologies. Global cumulative survival rates free from transplantation (SET) and Survival according to date of diagnosis were analyzed. Results: Despite similar PAR severity, patients with CPAH showed a more severe baseline impairment of 6-minute walking test (6MWT) (307 +/- 116 m vs 378 +/- 101 m) and diffusion capacity of the lung for carbon monoxide (DLCO) (57 +/- 25% vs 75 +/- 30% of predicted) than IPAH (p < 0.01). Survival rates at 1, 3 and 5 years of follow-up were 87%, 71% and 63% for IPAH, and 70%, 53% and 42% for CPAH, respectively (p < 0.05). IPAH showed better survival when treatment was started after Year 2000 (p = 0.01). However, CPAH showed a poorer prognosis than IPAH in the more recent era (p < 0.05). CPAH (hazard ratio [HR] = 2.03), DLCO <80% (HR = 1.98) and treatment before Year 2000 (HR = 2.27) were associated with an independent increased risk of death or transplantation. Conclusions: Despite similar functional and hemodynamic severity, patients with CPAH showed a more severe baseline impairment of 6MWT and DLCO and worse over-all prognosis than IPAH. Both IPAH and CPAH survival improved in the current era. Nevertheless, CPAH still showed a poorer prognosis than IPAH. J Heart Lung Transplant 2009;28:621-7. Copyright (C) 2009 by the International Society for Heart and Lung Transplantation.
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Formato Vancouver:
Ruiz Cano MJ, Escribano P, Alonso R, Delgado J, Carreira P, Velázquez T, et al. Comparison of baseline characteristics and survival between patients with idiopathic and connective tissue disease-related pulmonary arterial hypertension. J Heart Lung Transplant. 2009;28(6):621-7.

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Background: Both idiopathic pulmonary arterial hypertension (IPAH) and pulmonary arterial hypertension (PAH) related to connective tissue diseases (CPAH) are classified in the group of PAH disorders. However, CPAH has a particularly worse prognosis than IPAH. Few studies have compared the clinical, functional and hemodynamic profiles of IPAH and CPAH. Methods: We performed a retrospective cohort stud), of patients with IPAH or CPAH. Demographic characteristics, functional status (FE), pulmonary), function test and hemodynamic values at the time of diagnosis were compared between the two etiologies. Global cumulative survival rates free from transplantation (SET) and Survival according to date of diagnosis were analyzed. Results: Despite similar PAR severity, patients with CPAH showed a more severe baseline impairment of 6-minute walking test (6MWT) (307 +/- 116 m vs 378 +/- 101 m) and diffusion capacity of the lung for carbon monoxide (DLCO) (57 +/- 25% vs 75 +/- 30% of predicted) than IPAH (p < 0.01). Survival rates at 1, 3 and 5 years of follow-up were 87%, 71% and 63% for IPAH, and 70%, 53% and 42% for CPAH, respectively (p < 0.05). IPAH showed better survival when treatment was started after Year 2000 (p = 0.01). However, CPAH showed a poorer prognosis than IPAH in the more recent era (p < 0.05). CPAH (hazard ratio [HR] = 2.03), DLCO <80% (HR = 1.98) and treatment before Year 2000 (HR = 2.27) were associated with an independent increased risk of death or transplantation. Conclusions: Despite similar functional and hemodynamic severity, patients with CPAH showed a more severe baseline impairment of 6MWT and DLCO and worse over-all prognosis than IPAH. Both IPAH and CPAH survival improved in the current era. Nevertheless, CPAH still showed a poorer prognosis than IPAH. J Heart Lung Transplant 2009;28:621-7. Copyright (C) 2009 by the International Society for Heart and Lung Transplantation.

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