دورية أكاديمية
أعرض في EDS

Performance of risk stratification scores and role of comorbidities in older vs younger patients with pulmonary arterial hypertension.

التفاصيل البيبلوغرافية
العنوان: Performance of risk stratification scores and role of comorbidities in older vs younger patients with pulmonary arterial hypertension.
المؤلفون: Stolfo D; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University Hospital of Trieste, Trieste, Italy; Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. Electronic address: davide.stolfo@gmail.com., Barbisan D; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University Hospital of Trieste, Trieste, Italy., Ameri P; Cardiac, Vascular, and Thoracic Department, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine, University of Genova, Genova, Italy., Lombardi CM; Cardiology, ASST Spedali Civili; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Monti S; Cardiology and Pneumology Division, Fondazione Toscana G. Monasterio, Pisa, Italy; Institute of Clinical Physiology (IFC)-CNR, Pisa, Italy., Driussi M; Cardiology, Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy., Zovatto IC; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University Hospital of Trieste, Trieste, Italy., Gentile P; De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy., Howard L; Imperial College London, Faculty of Medicine, National Heart & Lung Institute, London, UK; National Pulmonary Hypertension Service, Department of Cardiology, Hammersmith Hospital, Imperial College NHS Trust, London, UK., Toma M; Cardiac, Vascular, and Thoracic Department, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine, University of Genova, Genova, Italy., Pagnesi M; Cardiology, ASST Spedali Civili; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Collini V; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University Hospital of Trieste, Trieste, Italy; Cardiology, Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy., Bauleo C; Cardiology and Pneumology Division, Fondazione Toscana G. Monasterio, Pisa, Italy., Guglielmi G; Cardiac, Vascular, and Thoracic Department, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine, University of Genova, Genova, Italy., Adamo M; Cardiology, ASST Spedali Civili; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., D'Angelo L; De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy., Nalli C; Cardiac Surgery, Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy., Sciarrone P; Cardiology and Pneumology Division, Fondazione Toscana G. Monasterio, Pisa, Italy., Moschella M; Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Zorzi B; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University Hospital of Trieste, Trieste, Italy; National Pulmonary Hypertension Service, Department of Cardiology, Hammersmith Hospital, Imperial College NHS Trust, London, UK., Vecchiato V; Cardiac, Vascular, and Thoracic Department, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine, University of Genova, Genova, Italy., Milani M; Università degli Studi di Milano-Bicocca, Milano, Italy., Di Poi E; Rheumatology Clinic, Department of Medicine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy., Airò E; Cardiology and Pneumology Division, Fondazione Toscana G. Monasterio, Pisa, Italy., Metra M; Cardiology, ASST Spedali Civili; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Garascia A; De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy., Sinagra G; Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University Hospital of Trieste, Trieste, Italy., Lo Giudice F; National Pulmonary Hypertension Service, Department of Cardiology, Hammersmith Hospital, Imperial College NHS Trust, London, UK.
المصدر: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation [J Heart Lung Transplant] 2023 Aug; Vol. 42 (8), pp. 1082-1092. Date of Electronic Publication: 2023 Mar 05.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 9102703 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-3117 (Electronic) Linking ISSN: 10532498 NLM ISO Abbreviation: J Heart Lung Transplant Subsets: MEDLINE
أسماء مطبوعة: Publication: 1999- : New York, NY : Elsevier
Original Publication: St. Louis, Mo. : Mosby-Year Book, Inc., c1991-
مواضيع طبية MeSH: Pulmonary Arterial Hypertension*/epidemiology , Hypertension, Pulmonary*, Humans ; Aged ; Familial Primary Pulmonary Hypertension ; Risk Factors ; Registries ; Risk Assessment
مستخلص: Background: Risk scores are important tools for the prognostic stratification of pulmonary arterial hypertension (PAH). Their performance and the additional impact of comorbidities across age groups is unknown.
Methods: Patients with PAH enrolled from 2001 to 2021 were divided in ≥65 years old vs <65 years old patients. Study outcome was 5-year all-cause mortality. French Pulmonary Hypertension Network (FPHN), FPHN noninvasive, Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA) and Registry to Evaluate Early and Long-term PAH Disease Management (REVEAL 2.0) risk scores were calculated and patients categorized at low, intermediate and high risk. Number of comorbidities was calculated.
Results: Among 383 patients, 152 (40%) were ≥65 years old. They had more comorbidities (number of comorbidities 2, IQR 1-3, vs 1, IQR 0-2 in <65 years patients). Five-year survival was 63% in ≥65 vs 90% in <65 years. Risk scores correctly discriminated the different classes of risk in the overall cohort and in the older and younger groups. REVEAL 2.0 showed the best accuracy in the total cohort (C-index 0.74, standard error-SE- 0.03) and older (C-index 0.69, SE 0.03) patients, whereas COMPERA 2.0 performed better in younger patients (C-index 0.75, SE 0.08). Number of comorbidities was associated with higher 5-year mortality, and consistently increased the accuracy of risk scores, in younger but not in older patients.
Conclusions: Risk scores have similar accuracy in the prognostic stratification of older vs younger PAH patients. REVEAL 2.0 had the best performance in older patients and COMPERA 2.0 had it in younger patients. Comorbidities increased the accuracy of risk scores only in younger patients.
(Copyright © 2023 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: comorbidities; old; pulmonary arterial hypertension; risk stratification scores; young
تواريخ الأحداث: Date Created: 20230402 Date Completed: 20230807 Latest Revision: 20230808
رمز التحديث: 20240628
DOI: 10.1016/j.healun.2023.02.1707
PMID: 37005100
قاعدة البيانات: MEDLINE
الوصف
تدمد:1557-3117
DOI:10.1016/j.healun.2023.02.1707