Abstract
Pulmonary hypertension (PH) is a life-limiting complication of severe lung disease [1, 2]. We investigate whether patients treated with pulmonary vasodilators survive longer.
Longitudinal haemodynamic, functional and treatment data from 184 consecutive incident group 3 PH patients with no connective tissue disease were prospectively collected from referral to death or censoring. Bayesian survival modelling assessed the association between treatment and survival.
Patients were in subgroups 3.2 (ILD, 71%), 3.1 (COPD, 21%), 3.3 (CPFE, 5%), 3.4 (2%), 3.5 (1%) and 3.7 (1%). Median follow-up was 1.6 years (IQR: 0.7 – 2.7) and 147 patients (80%) died. Patients treated with phosphodiesterase 5 inhibitors (PDE5i) had similar baseline lung function parameters, higher mPAP (40.4 ± 9.5 vs. 36.1 ± 10.4, p=0.02), lower cardiac output (CO: 3.7 vs 4.3 L/min, p<0.001) and worse echocardiographic right heart function by TAPSE and FAC but survived longer than those not on PDE5i (median: 2.58 vs 1.42 years, p=0.0069). Patients treated/not-treated with endothelin receptor antagonists had similar baseline haemodynamics but no difference in survival. Benefits of PDE5i were confined to subgroup 3.2 and greatest in young females with normal baseline TAPSE.
We suggest randomized controlled investigation of PDE5i in subgroup 3.2 patients is required to establish their long-term benefits.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, OA177.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021