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Risk categories from European guidelines applied to the French Pulmonary Hypertension (PH) registry

Athenais Boucly, Jason Weatherald, Xavier Jaïs, Vincent Cottin, Laurent Savale, Grégoire Prévot, François Picard, Pascal De Groote, Caroline O'Connell, Emmanuel Bergot, Ari Chaouat, Celine Chabanne, Arnaud Bourdin, Laurence Rottat, David Montani, Gerald Simonneau, Marc Humbert, Olivier Sitbon
European Respiratory Journal 2017 50: PA3527; DOI: 10.1183/1393003.congress-2017.PA3527
Athenais Boucly
1Hôpital Bicêtre - Le Kremlin-Bicêtre, France, France
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Jason Weatherald
2Department of Medicine, Division of Respirology, University of Calgary, Canada, Canada
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Xavier Jaïs
1Hôpital Bicêtre - Le Kremlin-Bicêtre, France, France
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Vincent Cottin
3Lyon University / Louis Pradel Hospital - Lyon, France, France
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Laurent Savale
1Hôpital Bicêtre - Le Kremlin-Bicêtre, France, France
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Grégoire Prévot
4Department of Pneumology, University Hospital - Toulouse, France, France
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François Picard
5Department of Cardiology, University Hospital - Bordeaux, France, France
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Pascal De Groote
6Department of Cardiology, CHRU - Lille, France, France
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Caroline O'Connell
1Hôpital Bicêtre - Le Kremlin-Bicêtre, France, France
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Emmanuel Bergot
7Department of Pneumology, University Hospital - Caen, France, France
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Ari Chaouat
8Department of Pneumology, CHRU, Lorraine University - Nancy, France, France
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Celine Chabanne
9Department of Cardiology, CHU - Rennes, France, France
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Arnaud Bourdin
10Hôpital Arnaud de Villeneuve - Montpellier, France, France
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Laurence Rottat
1Hôpital Bicêtre - Le Kremlin-Bicêtre, France, France
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David Montani
1Hôpital Bicêtre - Le Kremlin-Bicêtre, France, France
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Gerald Simonneau
1Hôpital Bicêtre - Le Kremlin-Bicêtre, France, France
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Marc Humbert
1Hôpital Bicêtre - Le Kremlin-Bicêtre, France, France
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Olivier Sitbon
1Hôpital Bicêtre - Le Kremlin-Bicêtre, France, France
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Abstract

Background: Current European (ERS/ESC) PH guidelines recommend risk assessment in patients with pulmonary arterial hypertension (PAH). The aim of our study were to analyze the association between the number of determinants of low-risk criteria achieved and long-term outcome.

Methods: All patients with idiopathic, heritable and drug-induced PAH entered into the French Registry from 2006 and reassessed within a year were analyzed. The Cox model was used to determine the weight of 4 low-risk criteria achieved at first follow-up visit: NYHA FC, 6MWD, right atrial pressure (RAP) and cardiac index (CI).

Results: 1017 patients were analyzed (mean age 57 yrs, 59% female, 75% iPAH). After a median follow-up of 34 months, 23% had died. In univariate analysis, HR (95%CI) for NYHA FC I-II, 6MWD>440 m, RAP<8 mmHg and CI≥2.5 L/min/m2 were 0.28 (0.21-0.36), 0.18 (0.12-0.27), 0.51 (0.39-0.65) and 0.50 (0.39-0.65), respectively. At first follow-up visit (5.6±3.4 mo.), the proportion of patients achieving 1, 2, 3 and 4 low-risk criteria were 22%, 27%, 24.5% and 17%, respectively. Figure 1 shows KM survival curves according to the number of low-risk criteria achieved. Three-year survival was 97%, 93%, 81%, 68% and 40% in patients who achieved 4, 3, 2, 1 and no low-risk criteria, respectively (p<0.00001).

Conclusion: These results support the relevance of ESC/ERS guidelines risk stratification to define treatment goals in patients with PAH.

  • Copyright ©the authors 2017
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Risk categories from European guidelines applied to the French Pulmonary Hypertension (PH) registry
Athenais Boucly, Jason Weatherald, Xavier Jaïs, Vincent Cottin, Laurent Savale, Grégoire Prévot, François Picard, Pascal De Groote, Caroline O'Connell, Emmanuel Bergot, Ari Chaouat, Celine Chabanne, Arnaud Bourdin, Laurence Rottat, David Montani, Gerald Simonneau, Marc Humbert, Olivier Sitbon
European Respiratory Journal Sep 2017, 50 (suppl 61) PA3527; DOI: 10.1183/1393003.congress-2017.PA3527

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Risk categories from European guidelines applied to the French Pulmonary Hypertension (PH) registry
Athenais Boucly, Jason Weatherald, Xavier Jaïs, Vincent Cottin, Laurent Savale, Grégoire Prévot, François Picard, Pascal De Groote, Caroline O'Connell, Emmanuel Bergot, Ari Chaouat, Celine Chabanne, Arnaud Bourdin, Laurence Rottat, David Montani, Gerald Simonneau, Marc Humbert, Olivier Sitbon
European Respiratory Journal Sep 2017, 50 (suppl 61) PA3527; DOI: 10.1183/1393003.congress-2017.PA3527
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