PMID- 28775050
OWN - NLM
STAT- MEDLINE
DCOM- 20180517
LR  - 20220409
IS  - 1399-3003 (Electronic)
IS  - 0903-1936 (Linking)
VI  - 50
IP  - 2
DP  - 2017 Aug
TI  - Risk assessment, prognosis and guideline implementation in pulmonary arterial 
      hypertension.
LID - 1700889 [pii]
LID - 10.1183/13993003.00889-2017 [doi]
AB  - Current European guidelines recommend periodic risk assessment for patients with 
      pulmonary arterial hypertension (PAH). The aim of our study was to determine the 
      association between the number of low-risk criteria achieved within 1 year of 
      diagnosis and long-term prognosis.Incident patients with idiopathic, heritable 
      and drug-induced PAH between 2006 and 2016 were analysed. The number of low-risk 
      criteria present at diagnosis and at first re-evaluation were assessed: World 
      Health Organization (WHO)/New York Heart Association (NYHA) functional class I or 
      II, 6-min walking distance (6MWD) >440 m, right atrial pressure <8 mmHg and 
      cardiac index >/=2.5 L.min(-1).m(-2)1017 patients were included (mean age 57 years, 
      59% female, 75% idiopathic PAH). After a median follow-up of 34 months, 238 (23%) 
      patients had died. Each of the four low-risk criteria independently predicted 
      transplant-free survival at first re-evaluation. The number of low-risk criteria 
      present at diagnosis (p<0.001) and at first re-evaluation (p<0.001) discriminated 
      the risk of death or lung transplantation. In addition, in a subgroup of 603 
      patients with brain natriuretic peptide (BNP) or N-terminal pro-brain natriuretic 
      peptide (NT-proBNP) measurements, the number of three noninvasive criteria 
      (WHO/NYHA functional class, 6MWD and BNP/NT-proBNP) present at first 
      re-evaluation discriminated prognostic groups (p<0.001).A simplified risk 
      assessment tool that quantifies the number of low-risk criteria present 
      accurately predicted transplant-free survival in PAH.
CI  - Copyright (c)ERS 2017.
FAU - Boucly, Athenais
AU  - Boucly A
AD  - Universite Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le 
      Kremlin-Bicetre, France.
AD  - AP-HP, Service de Pneumologie, Hopital Bicetre, Le Kremlin-Bicetre, France.
AD  - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France.
FAU - Weatherald, Jason
AU  - Weatherald J
AUID- ORCID: 0000-0002-0615-4575
AD  - AP-HP, Service de Pneumologie, Hopital Bicetre, Le Kremlin-Bicetre, France.
AD  - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France.
AD  - Department of Medicine, Division of Respirology, University of Calgary, Calgary, 
      AB, Canada.
FAU - Savale, Laurent
AU  - Savale L
AD  - Universite Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le 
      Kremlin-Bicetre, France.
AD  - AP-HP, Service de Pneumologie, Hopital Bicetre, Le Kremlin-Bicetre, France.
AD  - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France.
FAU - Jais, Xavier
AU  - Jais X
AD  - Universite Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le 
      Kremlin-Bicetre, France.
AD  - AP-HP, Service de Pneumologie, Hopital Bicetre, Le Kremlin-Bicetre, France.
AD  - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France.
FAU - Cottin, Vincent
AU  - Cottin V
AUID- ORCID: 0000-0002-5591-0955
AD  - Universite Lyon-1, Hospices Civils de Lyon, Centre de Reference des Maladies 
      Pulmonaires Rares, Centre de Competences de l'Hypertension Pulmonaire, Hopital 
      Louis Pradel, Lyon, France.
FAU - Prevot, Gregoire
AU  - Prevot G
AD  - Service de Pneumologie, Hopital Larrey, Toulouse, France.
FAU - Picard, Francois
AU  - Picard F
AD  - Service de Cardiologie, Hopital Haut-Leveque, Pessac, France.
FAU - de Groote, Pascal
AU  - de Groote P
AD  - Hopital Cardiologique de Lille, Centre de Competences de l'Hypertension 
      Pulmonaire, Lille, France.
FAU - Jevnikar, Mitja
AU  - Jevnikar M
AD  - Universite Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le 
      Kremlin-Bicetre, France.
AD  - AP-HP, Service de Pneumologie, Hopital Bicetre, Le Kremlin-Bicetre, France.
AD  - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France.
FAU - Bergot, Emmanuel
AU  - Bergot E
AD  - Hopital Cote de Nacre, Centre de Competences Basse Normandie de l'Hypertension 
      Pulmonaire, Universite de Caen-Basse Normandie, Caen, France.
FAU - Chaouat, Ari
AU  - Chaouat A
AD  - CHU Nancy, Pole des Specialites Medicales, Departement de Pneumologie, 
      Vandoeuvre-les-Nancy, France.
AD  - Universite de Lorraine, INGRES, EA 7298, Vandoeuvre-les-Nancy, France.
FAU - Chabanne, Celine
AU  - Chabanne C
AD  - CHU de Rennes, Service de Cardiologie et Maladies Vasculaires, INSERM U1099, 
      Rennes, France.
FAU - Bourdin, Arnaud
AU  - Bourdin A
AD  - Service de Pneumologie, Universite de Montpellier; INSERM U1046, UMR 9214, 
      Hopital Arnaud de Villeneuve, Montpellier, France.
FAU - Parent, Florence
AU  - Parent F
AD  - Universite Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le 
      Kremlin-Bicetre, France.
AD  - AP-HP, Service de Pneumologie, Hopital Bicetre, Le Kremlin-Bicetre, France.
AD  - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France.
FAU - Montani, David
AU  - Montani D
AUID- ORCID: 0000-0002-9358-6922
AD  - Universite Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le 
      Kremlin-Bicetre, France.
AD  - AP-HP, Service de Pneumologie, Hopital Bicetre, Le Kremlin-Bicetre, France.
AD  - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France.
FAU - Simonneau, Gerald
AU  - Simonneau G
AD  - Universite Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le 
      Kremlin-Bicetre, France.
AD  - AP-HP, Service de Pneumologie, Hopital Bicetre, Le Kremlin-Bicetre, France.
AD  - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France.
FAU - Humbert, Marc
AU  - Humbert M
AUID- ORCID: 0000-0003-0703-2892
AD  - Universite Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le 
      Kremlin-Bicetre, France.
AD  - AP-HP, Service de Pneumologie, Hopital Bicetre, Le Kremlin-Bicetre, France.
AD  - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France.
FAU - Sitbon, Olivier
AU  - Sitbon O
AD  - Universite Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le 
      Kremlin-Bicetre, France olivier.sitbon@bct.aphp.fr.
AD  - AP-HP, Service de Pneumologie, Hopital Bicetre, Le Kremlin-Bicetre, France.
AD  - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20170803
PL  - England
TA  - Eur Respir J
JT  - The European respiratory journal
JID - 8803460
RN  - 0 (Biomarkers)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
CIN - Eur Respir J. 2017 Aug 3;50(2):. PMID: 28775053
CIN - Eur Respir J. 2018 Mar 29;51(3):. PMID: 29599117
CIN - Eur Respir J. 2018 Mar 29;51(3):. PMID: 29599118
MH  - Adult
MH  - Aged
MH  - Atrial Pressure
MH  - Biomarkers/blood
MH  - Female
MH  - France/epidemiology
MH  - Humans
MH  - Hypertension, Pulmonary/classification/*diagnosis/*drug therapy/*mortality
MH  - Lung Transplantation
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Natriuretic Peptide, Brain/blood
MH  - Practice Guidelines as Topic
MH  - Prognosis
MH  - Registries
MH  - Retrospective Studies
MH  - *Risk Assessment
MH  - Survival Analysis
MH  - Walk Test
MH  - World Health Organization
COIS- Conflict of interest: Disclosures can be found alongside this article at 
      erj.ersjournals.com
EDAT- 2017/08/05 06:00
MHDA- 2018/05/18 06:00
CRDT- 2017/08/05 06:00
PHST- 2017/05/01 00:00 [received]
PHST- 2017/05/29 00:00 [accepted]
PHST- 2017/08/05 06:00 [entrez]
PHST- 2017/08/05 06:00 [pubmed]
PHST- 2018/05/18 06:00 [medline]
AID - 50/2/1700889 [pii]
AID - 10.1183/13993003.00889-2017 [doi]
PST - epublish
SO  - Eur Respir J. 2017 Aug 3;50(2):1700889. doi: 10.1183/13993003.00889-2017. Print 
      2017 Aug.