Journal
INTERNATIONAL JOURNAL OF CARDIOLOGY
Volume 300, Issue -, Pages 228-235Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijcard.2019.11.139
Keywords
Balloon pulmonary angioplasty; Combination therapy; Prognosis; Prognostic factors; Pulmonary hypertension
Categories
Funding
- Japanese Pulmonary Circulation Society [15K09116, 24591032]
- JapaneseMinistry of Education, Culture, Sports, Science and Technology, Tokyo, Japan
- Grants-in-Aid for Scientific Research [24591032, 15K09116] Funding Source: KAKEN
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Background: In the current era of treatment of pulmonary hypertension (PH) in Japan, combination therapy has been frequently used thanks to the medical insurance system. Additionally, pulmonary balloon angioplasty (BPA) is widely performed for chronic thromboembolic PH (CTEPH). Methods: To elucidate the long-term prognosis and the prognostic factors among all five subtypes of PH in this new era, we examined the current status of management of PH from November 2012 to April 2016 in the multicenter registry by the Japanese Pulmonary Circulation Society. Results: Among 1253 consecutive patients registered from 20 PH centers in Japan, we analyzed 997 patients with mean pulmonary arterial pressure >= 25 mmHg by right heart catheterization. Transplant-free survival at 5 years in pulmonary arterial hypertension (PAH). PH due to left-heart disease, PH due to lung diseases. CTEPH, and miscellaneous PH were 74.0, 69.3, 63.7, 92.0, and 55.3%, respectively. Of note, 32% of PAH patients were treated with double combination therapy and 42% of those with triple combination therapy, and 66% of CTEPH patients with BPA. Although PAH patients with triple combination therapy had worse hemodynamic parameters than those with other medications, triple combination therapy showed the best prognosis. BPA in (MPH improved survival even when adjusted for the key background factors. Conclusions: In the current era of PH treatment in Japan, the five-year transplant-free survival rate in this study was 74% for PAH and 92% for CTEPH, in which active combination medical therapy for PAH and higher performance rate of BPA for CTEPH may be involved. (C) 2019 Elsevier B.V. All rights reserved.
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