Lowering of mean pulmonary arterial pressure is a prognostic marker in pulmonary hypertension patients treated with subcutaneous treprostinil. (25th November 2020)

• Record Type: Journal Article
• Authors: Sadushi-Kolici, R; Shafran, I; Skoro-Sajer, N; Campean, I.-A; Lang, I.M
• Is Part Of: European heart journal. Volume 41:(2020)Supplement 2
• Publication Date: 2020-11-25
• Subjects: Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure - Treatment; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/ehjci/ehaa946.2255
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Background: Treprostinil (TRE), a prostacyclin analog, is effective for the treatment of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension (CTEPH). We hypothesized that change of hemodynamics is of prognostic value. In our prospective registry we evaluated effects of first-line subcutaneous (sc) TRE in patients with severe pulmonary hypertension (PH) and analyzed the prognostic value of hemodynamic changes from baseline on long-term follow-up. Methods: Data was collected from patients with pre-capillary PH in WHO functional class III or IV, mean right atrial pressure of ≥10mmHg, and/or cardiac index ≤2.2 liters/min/m 2 . Patients received first-line scTRE. Dose adjustments were performed individually according to clinical symptoms and side effects. Results: Between 1999 and 2018 138 patients were treated. Of these, 18 (13%) patients underwent double lung transplantation, and 59 (42.8%) died of any cause. Overall survival rates at 1, 5, 10, and 15 years were 91%, 57%, 31% and 29%. The strongest predictor of outcome was change in mPAP after one year of scTRE. Change in mPAP (−18.4±7.9 mmHg) was associated with the best subsequent survival of 12.7±1.5 years. Conclusion: The data suggest that patients benefit from aggressive lowering of mPAP in the first year of treatment. Funding Acknowledgement: Type of funding source: None