RT Journal Article
SR Electronic
T1 Relevance of comorbidities on initial combination therapy in pulmonary arterial hypertension
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00298-2022
DO 10.1183/23120541.00298-2022
VO 8
IS 4
A1 Badagliacca, Roberto
A1 D'Alto, Michele
A1 Ghio, Stefano
A1 Argiento, Paola
A1 Brunetti, Natale Daniele
A1 Casu, Gavino
A1 Cedrone, Nadia
A1 Confalonieri, Marco
A1 Corda, Marco
A1 Correale, Michele
A1 D'Agostino, Carlo
A1 De Michele, Lucrezia
A1 Di Marino, Serena
A1 Filomena, Domenico
A1 Galgano, Giuseppe
A1 Greco, Alessandra
A1 Lombardi, Carlo
A1 Manzi, Giovanna
A1 Mercurio, Valentina
A1 Mulè, Massimiliano
A1 Paciocco, Giuseppe
A1 Papa, Silvia
A1 Romeo, Emanuele
A1 Scelsi, Laura
A1 Stolfo, Davide
A1 Vitulo, Patrizio
A1 Vizza, Carmine Dario
A1 ,
YR 2022
UL http://openres.ersjournals.com/content/8/4/00298-2022.abstract
AB Rationale Demographic characteristics of pulmonary arterial hypertension (PAH) patients have changed over time, but the effects of cardiovascular risk factors on risk status and pulmonary vascular resistance (PVR) reduction with initial oral combination therapy are not known. Therefore, we tested the relevance of cardiovascular comorbidities in this setting.Methods The study enrolled 181 treatment-naive PAH patients with a 6-month (IQR 144–363 days) right heart catheterisation and risk assessment after initial oral combination therapy.Results Group A included 96 (53.0%) patients without cardiac comorbidities; Group B included 54 (29.8%) patients with one cardiac comorbidity; Group C included 31 (17.1%) patients with two cardiac comorbidities or more. Group C patients were older with a balanced sex distribution. There was a significant difference in PVR reduction moving from the absence to one or at least two cardiac comorbidities, respectively: median −45.0%, −30.3%, −24.3%. A European Respiratory Society/European Society of Cardiology low-risk status was present at first follow-up in 50 (52.0%) patients in Group A, 19 (35.1%) in Group B and 9 (29.0%) in Group C; a REVEAL 2.0 low-risk status was present at first follow-up in 41 (42.0%) patients in Group A, 15 (27.7%) in Group B and 7 (22.6%) in Group C. Group A patients were 2.3 times more likely to achieve/maintain a low-risk status compared with Group B and C (OR 2.27, 95% CI 1.15–4.54, p=0.02). No significant difference was observed between patients with non-cardiac comorbidities and those without comorbidities.Conclusion Initial oral combination therapy seems associated with a less effective response for patients with cardiovascular comorbidities compared with the others, related to the magnitude of treatment-induced decrease in PVR.In patients with pulmonary arterial hypertension, initial oral combination therapy is associated with a less effective response for those with cardiovascular comorbidities, related to the magnitude of treatment-induced decrease in PVR. https://bit.ly/3QB0Gd5