Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Hoeper, MM; Pausch, C; Olsson, KM; Huscher, D; Pittrow, D; Grünig, E; Staehler, G; Vizza, CD; Gall, H; Distler, O; Opitz, C; Gibbs, JSR; Delcroix, M; Ghofrani, HA; Park, DH; Ewert, R; Kaemmerer, H; Kabitz, HJ; Skowasch, D; Behr, J; Milger, K; Halank, M; Wilkens, H; Seyfarth, HJ; Held, M; Dumitrescu, D; Tsangaris, I; Vonk-Noordegraaf, A; Ulrich, S; Klose, H; Claussen, M; Lange, TJ; Rosenkranz, S.
COMPERA 2.0: a refined four-stratum risk assessment model for pulmonary arterial hypertension.
Eur Respir J. 2022; 60(1):
Doi: 10.1183/13993003.02311-2021
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- Co-Autor*innen der Med Uni Graz
- Milger-Kneidinger Katrin
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- Abstract:
- BACKGROUND: Risk stratification plays an essential role in the management of patients with pulmonary arterial hypertension (PAH). The current European guidelines propose a three-stratum model to categorise risk as low, intermediate or high, based on the expected 1-year mortality. However, with this model, most patients are categorised as intermediate risk. We investigated a modified approach based on four risk categories, with intermediate risk subdivided into intermediate-low and intermediate-high risk. METHODS: We analysed data from the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA), a European pulmonary hypertension registry, and calculated risk at diagnosis and first follow-up based on World Health Organization functional class, 6-min walk distance (6MWD) and serum levels of brain natriuretic peptide (BNP) or N-terminal pro-BNP (NT-proBNP), using refined cut-off values. Survival was assessed using Kaplan-Meier analyses, log-rank testing and Cox proportional hazards models. RESULTS: Data from 1655 patients with PAH were analysed. Using the three-stratum model, most patients were classified as intermediate risk (76.0% at baseline and 63.9% at first follow-up). The refined four-stratum risk model yielded a more nuanced separation and predicted long-term survival, especially at follow-up assessment. Changes in risk from baseline to follow-up were observed in 31.1% of the patients with the three-stratum model and in 49.2% with the four-stratum model. These changes, including those between the intermediate-low and intermediate-high strata, were associated with changes in long-term mortality risk. CONCLUSIONS: Modified risk stratification using a four-stratum model based on refined cut-off levels for functional class, 6MWD and BNP/NT-proBNP was more sensitive to prognostically relevant changes in risk than the original three-stratum model.
- Find related publications in this database (using NLM MeSH Indexing)
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- Peptide Fragments - administration & dosage
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