Pulmonary hypertension (PH) is severe progressive disease that without specific treatment leads to death in a few years. In Ukraine only in 2014 was organized first specialized department for PH patients mainly focused on pulmonary arterial hypertension (PAH) and chronic thromboembolic PH (CTEPH). Since 2016 Government drug supporting patient program was started. This study is the first analysis of patient survival after treatment in specialized department.
Long-term survival (Kaplan–Meier) and its predictors (Stepwise binary logistic regression and Cox’s proportional hazards analyses) were investigated in patients with PH (diagnosed by right heart catheterization) within a prospective registry at a single referral center in Kyiv, Ukraine. Follow-up period was up to 51 (mean 23,6±14,1) months. Only two specific drugs are available in Ukraine for treatment of PH: inhaled iloprost and sildenafil.
281 patients were enrolled (52 [18,5%] with CTEPH, 229 [81,5%] with PAH). Total estimated cumulative proportion surviving at 51th month was 81,5%. Univariate Cox’s predictors of death were: functional class IV (OR=4,94; 2,12-11,48), presence of ascites (OR=4,52; 2,21-9,24), CTD etiology of PAH (OR=3,07; 1,071-8,87); CHD etiology of PAH (OR=0,28; 0,11-0,68); HR on treatment> 105 beats per min (OR=7,85; 1,83-33,69); office systolic BP < 100 mmHg (OR=2,78; 1,26-6,1); 6 MWT< 340 m (OR=3,47; 1,008-12,35); NT-proBNP > 300 pg/ml (OR=4,98; 1,49-16,6); EchoCG right atrium square >22 sm2(OR=14,2; 1,92-104,89); EchoCG right ventricular square in diastole, sm2(OR=1,08; 1,025-1,14); EchoCG right ventricular square in systole, sm2(OR=1,08; 1,018-1,114). In multivariate Cox regression analyses only presence of ascites, office systolic BP< 100 mmHg, CHD etiology of PH, NT-proBNP > 300 pg/ml were associated with survival.
this is the first Ukrainian single-center PH cohort study results. Some simple patient’s parameters used in routine practice are independent survival predictors. EchoCG parameters were not independently associated with prognosis in our patients.
Key words: pulmonary hypertension, referral center, survival, predictors