Five year risk assessment and treatment patterns in patients with chronic thromboembolic pulmonary hypertension

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Five year risk assessment and treatment patterns in patients with chronic thromboembolic pulmonary hypertension

Kjellström, Barbro (author): Karolinska Institutet,Karolinska Institute,Lund University,Lunds universitet,Klinisk fysiologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Hjärt-MR-gruppen i Lund,Forskargrupper vid Lunds universitet,Clinical Physiology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund Cardiac MR Group,Lund University Research Groups,Skåne University Hospital

Bouzina, Habib (author): Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Lund Hemodynamic Lab,Forskargrupper vid Lunds universitet,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups

Björklund, Erik (author): Uppsala universitet,Kardiologi,Univ Hosp, Sweden,Uppsala University Hospital

Beaudet, Amélie (author): Actelion Pharmaceuticals, Allschwil, Switzerland,Actel Pharmaceut, Switzerland,Actelion Pharmaceuticals Ltd.

Edwards, Susan C. (author): Actelion Pharmaceuticals, Allschwil, Switzerland,Actel Pharmaceut, Switzerland,Actelion Pharmaceuticals Ltd.

Hesselstrand, Roger (author): Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Hjärt-lungsjukdom - information, stöd och bemötande,Forskargrupper vid Lunds universitet,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Cardiopulmonary disease - information, support and reception,Lund University Research Groups,Skåne University Hospital

Jansson, Kjell (author): Linköping University,Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Fysiologiska kliniken US

Nisell, Magnus (author): Lung Unit, Department of Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden,Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden

Rådegran, Göran (author): Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Hjärt-lungsjukdom - information, stöd och bemötande,Forskargrupper vid Lunds universitet,Lund Hemodynamic Lab,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Cardiopulmonary disease - information, support and reception,Lund University Research Groups,Skåne University Hospital

Sandqvist, Anna (author): Janssen Cilag AB, Solna, Sweden

Wåhlander, Håkan (author): Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics

Hjalmarsson, Clara, 1969 (author): Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine

Söderberg, Stefan (author): Umeå University,Umeå universitet,Avdelningen för medicin,Umea Univ, Sweden

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2022-07-04
2022
English.
In: ESC Heart Failure. - : John Wiley & Sons. - 2055-5822. ; 9:5, s. 3264-3274

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Journal article (peer-reviewed)

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Aims: Repeated risk assessments and treatment patterns over long time are sparsely studied in chronic thromboembolic pulmonary hypertension (CTEPH); thus, we aimed to investigate changes in risk status and treatment patterns in incident patients with CTEPH over a 5 year period.Methods and results: Descriptive and explorative study including 311 patients diagnosed with CTEPH 2008–2019 from the Swedish pulmonary hypertension registry, stratified by pulmonary endarterectomy surgery (PEA). Risk and PH-specific treatment were assessed in surgically treated (PEA) and medically treated (non-PEA) patients at diagnosis and up to 5 years follow-up. Data are presented as median (Q1–Q3), count or per cent. Prior to surgery, 63% in the PEA-group [n = 98, age 64 (51–71) years, 37% female] used PH-specific treatment and 20, 69, and 10% were assessed as low, intermediate or high risk, respectively. After 1 year post-surgery, 34% had no PH-specific treatment or follow-up visit registered despite being alive at 5 years. Of patients with a 5 year visit (n = 23), 46% were at low and 54% at intermediate risk, while 91% used PH-specific treatment. In the non-PEA group [n = 213, age 72 (65–77) years, 56% female], 28% were assessed as low, 61% as intermediate and 11% as high risk. All patients at high risk versus 50% at low risk used PH-specific treatment. The 1 year mortality was 6%, while the risk was unchanged in 57% of the patients; 14% improved from intermediate to low risk, and 1% from high to low risk. At 5 years, 27% had a registered visit and 28% had died. Of patients with a 5 year visit (n = 58), 38% were at low, 59% at intermediate and 1% at high risk, and 86% used PH-specific treatment.Conclusions: Risk status assessed pre-surgery did not foresee long-term post-PEA risk and pre-surgery PH-specific treatment did not foresee long-term post-PEA treatment. Medically treated CTEPH patients tend to remain at the same risk over time, suggesting a need for improved treatment strategies in this group.

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By the author/editor: Kjellström, Barb ...; Bouzina, Habib; Björklund, Erik; Beaudet, Amélie; Edwards, Susan C ...; Hesselstrand, Ro ...; show more...; Jansson, Kjell; Nisell, Magnus; Rådegran, Göran; Sandqvist, Anna; Wåhlander, Håkan; Hjalmarsson, Cla ...; Söderberg, Stefa ...; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

Articles in the publication: ESC Heart Failur ...

By the university: Umeå University; Uppsala University; Linköping University; Lund University; Karolinska Institutet; University of Gothenburg

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Five year risk assessment and treatment patterns in patients with chronic thromboembolic pulmonary hypertension

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