PMID- 29642071
OWN - NLM
STAT- MEDLINE
DCOM- 20181221
LR  - 20181221
IS  - 1423-0356 (Electronic)
IS  - 0025-7931 (Linking)
VI  - 96
IP  - 2
DP  - 2018
TI  - Risk Factor Profiles Achieved with Medical Therapy in Prevalent Patients with 
      Pulmonary Arterial and Distal Chronic Thromboembolic Pulmonary Hypertension.
PG  - 127-137
LID - 10.1159/000488000 [doi]
AB  - BACKGROUND: The latest pulmonary hypertension (PH) guidelines define therapeutic 
      goals in terms of symptoms, exercise capacity, and haemodynamics for patients 
      with pulmonary arterial hypertension (PAH) and recommend advanced combined 
      medical therapy. For inoperable or post-surgical residual distal chronic 
      thromboembolic PH (CTEPH) medical treatment is similarly advised. OBJECTIVES: We 
      analysed whether risk factor goals are achieved and combination therapy is used 
      in prevalent patients with PAH or distal CTEPH. METHODS: PAH or distal CTEPH 
      patients who were seen at the University Hospital Zurich during the last year 
      were analysed in terms of demography, clinical data, medication, and therapeutic 
      goals. Achievement of therapeutic goals was defined as New York Heart Association 
      (NYHA) class </=II, N-terminal pro-brain natriuretic peptide (NTpro-BNP) < 300 
      ng/L, and 6-min walking distance (6MWD) > 440 m. RESULTS: A total of 108 PAH 
      patients (age 59 +/- 18 years, 62% female, 64% idiopathic, 36% associated) and 38 
      distal CTEPH patients (age 69 +/- 14 years, 55% female) were included. They had 
      been diagnosed on average 66 +/- 48 months (+/-SD) previously. The percentage of 
      PAH/CTEPH patients with NYHA </=II was 52/53, respectfully, the percentage of those 
      with NTproBNP < 300 ng/L was 61/52, and with 6MWD > 440 m 63/50. Overall, 33/31% 
      fulfilled 3 and 29/35% fulfilled 2 of these goals. Regarding therapy, 43% of PAH 
      patients were on double and 10% on triple combination therapy, whereas 16% of 
      distal CTEPH patients were on double and 3% on triple combination therapy. 
      CONCLUSIONS: In this real-life cohort of prevalent patients with PAH or distal 
      CTEPH, targeted drug therapy resulted in an achievement of >/=2/3 predefined 
      therapeutic goals in 2/3 of patients. Patients with PAH were more likely to 
      receive combination therapy compared to CTEPH patients.
CI  - (c) 2018 S. Karger AG, Basel.
FAU - Bartenstein, Philipp
AU  - Bartenstein P
FAU - Saxer, Stephanie
AU  - Saxer S
FAU - Appenzeller, Paula
AU  - Appenzeller P
FAU - Lichtblau, Mona
AU  - Lichtblau M
FAU - Schwarz, Esther I
AU  - Schwarz EI
FAU - Ulrich, Silvia
AU  - Ulrich S
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180411
PL  - Switzerland
TA  - Respiration
JT  - Respiration; international review of thoracic diseases
JID - 0137356
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antihypertensive Agents/*therapeutic use
MH  - Body Mass Index
MH  - Chronic Disease
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/*drug therapy/etiology/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/blood
MH  - Peptide Fragments/blood
MH  - Risk Factors
MH  - Thromboembolism/*complications
MH  - Treatment Outcome
MH  - Walk Test
OTO - NOTNLM
OT  - Chronic thromboembolic pulmonary hypertension
OT  - Combination therapy
OT  - Pulmonary arterial hypertension
OT  - Risk stratification
OT  - Therapeutic goals
EDAT- 2018/04/12 06:00
MHDA- 2018/12/24 06:00
CRDT- 2018/04/12 06:00
PHST- 2018/01/10 00:00 [received]
PHST- 2018/02/26 00:00 [accepted]
PHST- 2018/04/12 06:00 [pubmed]
PHST- 2018/12/24 06:00 [medline]
PHST- 2018/04/12 06:00 [entrez]
AID - 000488000 [pii]
AID - 10.1159/000488000 [doi]
PST - ppublish
SO  - Respiration. 2018;96(2):127-137. doi: 10.1159/000488000. Epub 2018 Apr 11.