Prognosis in Hispanic patient population with pulmonary arterial hypertension: An application of common risk stratification models

Fadah, Kahtan; Rodríguez, José Cruz Carrillo; Alkhateeb, Haider; Mukherjee, Debabrata; Garcia, Hernando; Schuller, Dan; Mohammad, Khan O.; Sahay, Sandeep; Nickel, Nils

doi:10.1002/pul2.12209

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…Our study also found that studies conducted in Europe showed lower mortality than those in the America. This could be attributed to a multitude of factors related to healthcare infrastructure, treatment availability and patient demographics 26 28–31. Cultural and socioeconomic factors may also play a role in these disparities and impact the overall healthcare-seeking behaviour of individuals in different regions 31–34…”

Section: Discussionmentioning

confidence: 99%

Pulmonary hypertension survival and hospitalisations in people living with HIV: a systematic review and meta-analysis

Youssef,

Boutros Salama,

Rehman

et al. 2024

BMJ Open Resp Res

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IntroductionPeople living with HIV (PLHIV) have a higher risk of developing pulmonary hypertension (PH) with subsequent poorer prognosis. This review aimed to determine the (1) survival outcomes and (2) proportion of emergency department (ED) visits and hospitalisations of PLHIV and PH.MethodsWe conducted a systematic review and meta-analysis of observational studies reporting survival outcomes for PLHIV and PH. Electronic databases (Medline, EMBASE, PubMed, Web of Science, Global Index Medicus and Cochrane Library), trial registries and conference proceedings were searched until 22 July 2023. We pooled similar measures of effect, assessed apriori subgroups and used meta-regression to determine mortality and associated variables.Results5248 studies were identified; 28 studies were included with a total of 5459 PLHIV and PH. The mean survival (95% CI) of PLHIV and PH was 37.4 months (29.9 to 44.8). Participants alive at 1, 2 and 3 years were 85.8% (74.1% to 95.0%), 75.2% (61.9% to 86.7%) and 61.9% (51.8% to 71.6%), respectively. ED visits and hospitalisation rates were 73.3% (32.5% to 99.9%) and 71.2% (42.4% to 94.2%), respectively. More severe disease, measured by echocardiogram, was associated with poorer prognosis (β −0.01, 95% CI −0.02 to 0.00, p=0.009). Survival was higher in high-income countries compared with lower-income countries (β 0.50, 95% CI 0.28 to 0.73, p<0.001) and in Europe compared with the America (β 0.56, 95% CI 0.37 to 0.75, p<0.001).ConclusionOur study confirms poor prognosis and high healthcare utilisation for PLHIV and PH. Prognosis is associated with country income level, geographic region and PH severity. This highlights the importance of screening in this population.PROSPERO registration numberCRD42023395023.

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Section: Discussionmentioning

confidence: 99%

Pulmonary hypertension survival and hospitalisations in people living with HIV: a systematic review and meta-analysis

Youssef,

Boutros Salama,

Rehman

et al. 2024

BMJ Open Resp Res

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“…Studies have shown that Hispanics free of known cardiovascular disease have a higher RV mass and RV end-diastolic volume at baseline than other ethnicities [6]. Moreover, Hispanic patients with PAH appear to have a survival benefit compared to other PAH ethnicities [7,8]. However, the extent, validity, and potential reasons for this survival advantage remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Insights Into Differences in Pulmonary Hemodynamics in Hispanic Patients With Pulmonary Arterial Hypertension

Fadah,

Arrington,

Khalafi

et al. 2024

Cardiol Res

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Background: Emerging data suggest that Hispanic patients with pulmonary arterial hypertension (PAH) exhibit improved survival rates compared to individuals of other ethnicities with similar baseline hemodynamics. However, the underlying reasons for this survival advantage remain unclear. This study focused on comparing pulmonary hemodynamics in Hispanic and non-Hispanic PAH patients and how these differences may contribute to varied clinical outcomes.Methods: A retrospective analysis of right heart catheterization data was conducted on a treatment-naive PAH patient cohort from a single center.Results: Over a 10-year period, a total of 226 PAH patients were identified, of which 138 (61%) were Hispanic and 88 (39%) were non-Hispanic. Hispanic patients presented with lower pulmonary artery pressures, lower pulmonary vascular resistance, and exhibited significantly higher pulmonary arterial compliance (PAc). Hispanic patients had better 5-year survival rates. Conclusions:This study highlights the importance of exploring phenotypic differences in ethnically diverse PAH cohorts.

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Frequency, characteristics and risk assessment of pulmonary arterial hypertension with a left heart disease phenotype

Toma,

Savonitto,

Lombardi

et al. 2024

Clin Res Cardiol

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Aim To obtain real-world evidence about the features and risk stratification of pulmonary arterial hypertension (PAH) with a left heart disease (LHD) phenotype (PAH-LHD). Methods and results By reviewing the records of consecutive incident PAH patients at 7 tertiary centers from 2001 to 2021, we selected 286 subjects with all parameters needed to determine risk of death at baseline and at first follow-up with COMPERA and COMPERA 2.0 scores. Fifty seven (20%) had PAH-LHD according to the AMBITION definition. Compared with no-LHD ones, they were older, had higher BMI, more cardiovascular comorbidities, higher E/e’ ratio and left atrial area, but lower BNP concentrations and better right ventricular function and pulmonary hemodynamics. Survival was comparable between PAH-LHD and no-LHD patients, although the former were less commonly treated with dual PAH therapy. Both COMPERA and COMPERA 2.0 discriminated all-cause mortality risk of PAH-LHD at follow-up, but not at baseline. Risk profile significantly improved during follow-up only when assessed by COMPERA 2.0. At multivariable analysis with low-risk status as reference, intermediate-high and high-risk, but not LHD phenotype, were associated with higher hazard of all-cause mortality. Results were comparable in secondary analyses including patients in the last 10 years and atrial fibrillation and echocardiographic abnormalities as additional criteria for PAH-LHD. Conclusions In real life, PAH-LHD patients are frequent, have less severe disease and are less likely treated with PAH drug combinations than no-LHD. The COMPERA 2.0 model may be more appropriate to evaluate their mortality risk during follow-up and how it is modulated by therapy.

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Prognosis in Hispanic patient population with pulmonary arterial hypertension: An application of common risk stratification models

Cited by 4 publications

References 29 publications

Pulmonary hypertension survival and hospitalisations in people living with HIV: a systematic review and meta-analysis

Pulmonary hypertension survival and hospitalisations in people living with HIV: a systematic review and meta-analysis

Insights Into Differences in Pulmonary Hemodynamics in Hispanic Patients With Pulmonary Arterial Hypertension

Frequency, characteristics and risk assessment of pulmonary arterial hypertension with a left heart disease phenotype

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