Chest
Original ResearchPulmonary Vascular DiseaseBaseline and Follow-up 6-Min Walk Distance and Brain Natriuretic Peptide Predict 2-Year Mortality in Pulmonary Arterial Hypertension
Section snippets
Materials and Methods
This study was approved by the Institutional Review Board of the University of Pennsylvania (approval No. 814307). Additional details of the methods and statistical analysis are provided in e-Appendix 1.
ARIES (Ambrisentan in Pulmonary Arterial Hypertension, Randomized, Double-Blind, Placebo-Controlled, Multicenter, Efficacy Study)-1 and ARIES-2 were concurrent, phase 3, double-blind, placebo-controlled RCTs of ambrisentan for the treatment of PAH.8 Patients were randomized to placebo or
Results
There were 383 subjects in the study cohort (Fig 1). We excluded 13 who did not have 2-year survival status data from the primary analyses, leaving 370 subjects in the study sample for the 6MWD analysis. Thirty-seven additional subjects were excluded from the BNP analyses due to missing baseline BNP values, leaving 333 in the study sample. Baseline demographics of the study samples and those excluded are presented in Table 1, Table 2, for descriptive purposes only. Most patients had idiopathic
Discussion
In this study, we assessed the ability of baseline and 12-week 6MWD and BNP levels to discriminate PAH patients with a high vs low risk of death at 2 years after treatment with ambrisentan. Both 6MWD at baseline and at 12 weeks after treatment displayed moderately strong predictive ability for discriminating patients at high and low risks of death at 2 years. Similar findings were observed for baseline and 12-week BNP levels, although these were somewhat weaker predictors. A baseline 6MWD < 250
Acknowledgments
Author contributions: Drs Fritz and Kawut guarantee the integrity of the study.
Dr Fritz: contributed to study conception and design, data analysis and interpretation, as well as article drafting and revision, and gave final approval.
Ms Blair: contributed to data analysis and interpretation as well as article revision and gave final approval.
Dr Oudiz: contributed to data analysis and interpretation as well as article revision and gave final approval.
Dr Dufton: contributed to data analysis and
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Funding/Support: This work was supported by the National Institutes of Health [K24 HL103844 to S. M. K.].