Hospitalisation Is Prognostic of Survival in Chronic Thromboembolic Pulmonary Hypertension
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Study Design and Outcome Measures
2.3. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Landmark Analysis: Operable vs. Inoperable
3.3. Landmark Analysis: Operated vs. Not-Operated
3.4. Landmark Analysis of Operable Subgroups: Already-Operated vs. Not-Currently-Operated
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Month 3 Landmark | Month 6 Landmark | Month 9 Landmark | Month 12 Landmark | |||||
---|---|---|---|---|---|---|---|---|
Parameter | Prior Hospitalisation Event (n = 14) | No Prior Hospitalisation Event (n = 113) | Prior Hospitalisation Event (n = 19) | No Prior Hospitalisation Event (n = 103) | Prior Hospitalisation Event (n = 27) | No Prior Hospitalisation Event (n = 94) | Prior Hospitalisation Event (n = 30) | No Prior Hospitalisation Event (n = 89) |
Age, mean (SD), years | 65.7 (10.04) | 66.7 (13.05) | 64.6 (13.11) | 66.8 (12.89) | 64.2 (12.53) | 67.1 (13.06) | 64.1 (12.80) | 67.2 (13.12) |
Sex, n (%), female | 9 (64.3%) | 61 (54.0%) | 12 (63.2%) | 56 (54.4%) | 13 (48.1%) | 55 (58.5%) | 16 (53.3%) | 51 (57.3%) |
BMI, mean (SD), kg/m2 [n] | 28.1 (5.67) [13] | 28.3 (5.08) [105] | 28.7 (5.11) [17] | 28.4 (5.08) [97] | 28.9 (4.49) [25] | 28.4 (5.20) [88] | 29.7 (4.03) [28] | 28.2 (5.24) [84] |
DVT history, n (%) | 3 (21.4%) | 40 (36.0%) | 5 (27.8%) | 37 (36.3%) | 7 (26.9%) | 35 (37.6%) | 9 (31.0%) | 32 (36.4%) |
PE history, n (%) | 10 (71.4%) | 82 (72.6%) | 11 (57.9%) | 77 (74.8%) | 18 (66.7%) | 69 (73.4%) | 21 (70.0%) | 66 (74.2%) |
Time from first PE to diagnosis, mean (SD), years | 5.4 (8.22) | 5.2 (7.03) | 6.0 (7.55) | 5.1 (7.20) | 6.7 (7.76) | 4.9 (7.09) | 6.5 (7.63) | 4.9 (7.10) |
NYHA FC, n (%) [n] | ||||||||
FC I/II | – | 4 (4.0%) [101] | – | 4 (4.3%) [92] | – | 4 (4.8%) [84] | – | 4 (5.1%) [79] |
FC III/IV | 12 (100%) [12] | 97 (96.0%) [101] | 16 (100%) [16] | 88 (95.7%) [92] | 24 (100%) [24] | 80 (95.2%) [84] | 27 (100%) [27] | 75 (94.9%) [79] |
6MWT, mean (SD), metres [n] | 269.7 (104.9) [11] | 337.8 (112.4) [82] | 279.8 (133.5) [14] | 343.8 (107.7) [75] | 309.6 (127.7) [21] | 341.1 (109.0) [68] | 308.8 (121.7) [24] | 348.0 (107.9) [63] |
RHC | ||||||||
mPAP, mean (SD), mmHg [n] | 50.1 (12.60) [13] | 43.2 (11.69) [108] | 51.3 (14.65) [18] | 42.5 (11.03) [99] | 50.2 (12.89) [25] | 42.0 (11.29) [91] | 50.1 (13.03) [28] | 41.5 (11.09) [86] |
PVR, mean (SD), dyn s/cm5 [n] | 905.1 (381.1) [12] | 629.2 (325.5) [107] | 822.6 (430.6) [17] | 613.0 (311.6) [98] | 765.3 (389.7) [24] | 604.7 (311.8) [90] | 716.4 (365.3) [27] | 601.5 (314.6) [85] |
CI, mean (SD), L/min/m2 [n] | 2.0 (0.40) [12] | 2.3 (0.58) [106] | 2.3 (0.64) [17] | 2.3 (0.56) [97] | 2.3 (0.60) [24] | 2.3 (0.56) [89] | 2.4 (0.64) [27] | 2.3 (0.54) [84] |
BNP, mean (SD), pg/mL [n] | 745.0 (475.7) [6] | 284.4 (322.9) [49] | 445.5 (312.1) [8] | 289.4 (332.2) [46] | 350.0 (276.1) [13] | 300.6 (349.1) [41] | 264.8 (251.4) [15] | 294.0 (323.9) [37] |
Anticoagulation, n (%) | ||||||||
NOAC | 1 (7.1%) | 4 (3.5%) | 1 (5.3%) | 4 (3.9%) | 1 (3.7%) | 4 (4.3%) | 1 (3.3%) | 4 (4.5%) |
Vitamin K antagonist | 11 (78.6%) | 99 (87.6%) | 15 (78.9%) | 91 (88.3%) | 23 (85.2%) | 82 (87.2%) | 26 (86.7%) | 78 (87.6%) |
Other anticoagulants | 2 (14.3%) | 10 (8.8%) | 3 (15.8%) | 8 (7.8%) | 3 (11.1%) | 8 (8.5%) | 3 (10.0%) | 7 (7.9%) |
Time to diagnosis from study start 1, mean (SD), years | 8.91 (3.631) | 7.66 (3.103) | 8.02 (3.372) | 7.78 (3.143) | 7.69 (2.871) | 7.79 (3.218) | 7.98 (2.887) | 7.68 (3.253) |
Month 3 Landmark | Month 6 Landmark | Month 9 Landmark | Month 12 Landmark | |||||
---|---|---|---|---|---|---|---|---|
Parameter | Prior Hospitalisation Event (n = 62) | No Prior Hospitalisation Event (n = 247) | Prior Hospitalisation Event (n = 81) | No Prior Hospitalisation Event (n = 214) | Prior Hospitalisation Event (n = 96) | No Prior Hospitalisation Event (n = 196) | Prior Hospitalisation Event (n = 105) | No Prior Hospitalisation Event (n = 182) |
Age, mean (SD), years | 64.4 (10.59) | 60.7 (12.65) | 62.8 (11.54) | 60.7 (12.84) | 61.3 (12.08) | 61.3 (12.72) | 60.8 (13.06) | 61.5 (12.28) |
Sex, n (%), female | 28 (45.2%) | 100 (40.5%) | 39 (48.1%) | 84 (39.3%) | 46 (47.9%) | 76 (38.8%) | 51 (48.6%) | 70 (38.5%) |
BMI, mean (SD), kg/m2 [n] | 28.5 (6.08) [53] | 28.4 (5.54) [208] | 28.1 (5.12) [66] | 28.5 (5.65) [184] | 28.5 (5.27) [79] | 28.3 (5.65) [168] | 28.4 (5.30) [89] | 28.4 (5.59) [154] |
DVT history, n (%) | 27 (45.8%) | 106 (43.1%) | 35 (44.3%) | 93 (43.7%) | 40 (42.6%) | 85 (43.6%) | 45 (43.7%) | 79 (43.6%) |
PE history, n (%) | 50 (80.6%) | 196 (79.4%) | 66 (81.5%) | 170 (79.4%) | 75 (78.1%) | 158 (80.6%) | 84 (80.0%) | 146 (80.2%) |
Time from first PE to diagnosis, mean (SD), years | 7.1 (8.70) | 4.9 (7.19) | 5.5 (6.54) | 5.0 (7.49) | 5.8 (7.77) | 4.7 (6.94) | 5.7 (7.57) | 4.8 (7.07) |
NYHA FC, n (%) [n] | ||||||||
FC I/II | 2 (3.2%) [62] | 30 (12.2%) [246] | 5 (6.2%) [81] | 26 (12.2%) [213] | 5 (5.2%) [96] | 25 (12.8%) [195] | 6 (5.8%) [104] | 24 (13.2%) [182] |
FC III/IV | 60 (96.8%) [62] | 216 (87.8%) [246] | 76 (93.8%) [81] | 187 (87.8%) [213] | 91 (94.8%) [96] | 170 (87.2%) [195] | 98 (94.2%) [104] | 158 (86.8%) [182] |
6MWT, mean (SD), metres [n] | 305.6 (102.3) [49] | 354.0 (107.4) [217] | 309.5 (94.79) [67] | 361.4 (108.4) [186] | 309.0 (98.60) [83] | 365.9 (106.5) [169] | 316.7 (102.4) [90] | 366.5 (106.0) [157] |
RHC | ||||||||
mPAP, mean (SD), mmHg [n] | 52.0 (12.97) [62] | 47.8 (12.58) [240] | 50.7 (12.50) [79] | 47.5 (12.63) [209] | 50.8 (12.30) [94] | 47.1 (12.71) [191] | 50.4 (12.45) [102] | 47.0 (12.63) [178] |
PVR, mean (SD), dyn s/cm5 [n] | 802.2 (319.2) [62] | 730.2 (347.3) [239] | 807.3 (344.8) [79] | 714.4 (333.0) [208] | 783.9 (324.7) [94] | 714.3 (341.4) [190] | 780.4 (336.4) [101] | 704.5 (319.7) [179] |
CI, mean (SD), L/min/m2 [n] | 2.2 (0.45) [61] | 2.3 (0.53) [234] | 2.2 (0.46) [78] | 2.3 (0.52) [203] | 2.2 (0.46) [93] | 2.3 (0.52) [185] | 2.2 (0.50) [101] | 2.3 (0.50) [172] |
BNP, mean (SD), pg/mL [n] | 313.5 (251.7) [18] | 392.9 (597.1) [113] | 267.0 (234.1) [25] | 397.8 (601.8) [102] | 311.4 (341.4) [34] | 395.8 (613.0) [92] | 316.6 (349.4) [36] | 373.8 (605.5) [88] |
Anticoagulation, n (%) [n] | ||||||||
NOAC | – | 7 (2.9%) [244] | – | 7 (3.3%) [214] | – | 7 (3.6%) [196] | – | 7 (3.8%) [182] |
Vitamin K antagonist | 47 (75.8%) [62] | 208 (85.2%) [244] | 68 (84.0%) [81] | 179 (83.6%) [214] | 81 (84.4%) [96] | 164 (83.7%) [196] | 90 (85.7%) [105] | 150 (82.4%) [182] |
Other anticoagulants | 15 (24.2%) [62] | 29 (11.9%) [244] | 13 (16.0%) [81] | 28 (13.1%) [214] | 15 (15.6%) [96] | 25 (12.8%) [196] | 15 (14.3%) [105] | 25 (13.7%) [182] |
Time to diagnosis from study start 1, mean (SD), years | 6.60 (3.253) | 7.58 (3.434) | 6.21 (3.179) | 7.87 (3.395) | 6.41 (3.273) | 7.88 (3.393) | 6.51 (3.472) | 7.90 (3.333) |
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Jansa, P.; Ambrož, D.; Aschermann, M.; Černý, V.; Dytrych, V.; Heller, S.; Kunstýř, J.; Lindner, J.; Linhart, A.; Nižnanský, M.; et al. Hospitalisation Is Prognostic of Survival in Chronic Thromboembolic Pulmonary Hypertension. J. Clin. Med. 2022, 11, 6189. https://doi.org/10.3390/jcm11206189
Jansa P, Ambrož D, Aschermann M, Černý V, Dytrych V, Heller S, Kunstýř J, Lindner J, Linhart A, Nižnanský M, et al. Hospitalisation Is Prognostic of Survival in Chronic Thromboembolic Pulmonary Hypertension. Journal of Clinical Medicine. 2022; 11(20):6189. https://doi.org/10.3390/jcm11206189
Chicago/Turabian StyleJansa, Pavel, David Ambrož, Michael Aschermann, Vladimír Černý, Vladimír Dytrych, Samuel Heller, Jan Kunstýř, Jaroslav Lindner, Aleš Linhart, Matúš Nižnanský, and et al. 2022. "Hospitalisation Is Prognostic of Survival in Chronic Thromboembolic Pulmonary Hypertension" Journal of Clinical Medicine 11, no. 20: 6189. https://doi.org/10.3390/jcm11206189