Hideki Miwa1, Nobuhiro Tanabe1,2, Takayuki Jujo1,2, Fumiaki Kato1, Rie Anazawa1, Keiko Yamamoto1, Akira Naito1,3, Hajime Kasai1, Rintaro Nishimura1, Rika Suda1, Toshihiko Sugiura1, Seiichiro Sakao1, Keiichi Ishida4,5, Masahisa Masuda5,6, Koichiro Tatsumi1. 1. Department of Respirology, Graduate School of Medicine, Chiba University. 2. Department of Advanced Medicine in Pulmonary Hypertension, Graduate School of Medicine, Chiba University. 3. Department of Advancing Research on Treatment Strategies for Respiratory, Graduate School of Medicine, Chiba University. 4. Department of Cardiovascular Surgery, Graduate School of Medicine, Chiba University. 5. Department of Cardiovascular Surgery, Eastern Chiba Medical Center. 6. Department of Cardiovascular Surgery, National Hospital Organization, Chiba Medical Center.
Abstract
BACKGROUND: Several new treatments for chronic thromboembolic pulmonary hypertension (CTEPH) have appeared in recent years, which have led to changes in the treatment algorithm. Changes in survival rates and prognostic factors, however, have not been estimated so far.Methods and Results: Two hundred and eighty patients were diagnosed with CTEPH at Chiba University Hospital between June 1986 and June 2016. Survival rate was investigated by date of treatment initiation (group 1, 1986-1998; group 2, 1999-2008; group 3, 2009-2016). Survival rates were also evaluated by treatment strategy: balloon pulmonary angioplasty (BPA), pulmonary endarterectomy (PEA), and medical treatment. Group 3 had significantly better disease-specific survival than groups 1 and 2 (5-year survival: 91.9% vs. 67.1%, 77.0%, respectively). For the non-PEA (BPA+medication) strategy, group 3 had better disease-specific survival than groups 1 and 2 (5-year survival: 94.9% vs. 54.6%, 74.2%, respectively). The PEA strategy had significantly better survival than the medication strategy in groups 1 and 2, whereas no difference was observed between the BPA, PEA, and medication strategies in group 3. CONCLUSIONS: Survival in CTEPH in the recent era has significantly improved, especially in non-PEA patients. BPA and selective pulmonary vasodilators could improve survival in the non-PEA group. In the present study, no difference in survival was found between PEA and non-PEA.
BACKGROUND: Several new treatments for chronic thromboembolic pulmonary hypertension (CTEPH) have appeared in recent years, which have led to changes in the treatment algorithm. Changes in survival rates and prognostic factors, however, have not been estimated so far.Methods and Results: Two hundred and eighty patients were diagnosed with CTEPH at Chiba University Hospital between June 1986 and June 2016. Survival rate was investigated by date of treatment initiation (group 1, 1986-1998; group 2, 1999-2008; group 3, 2009-2016). Survival rates were also evaluated by treatment strategy: balloon pulmonary angioplasty (BPA), pulmonary endarterectomy (PEA), and medical treatment. Group 3 had significantly better disease-specific survival than groups 1 and 2 (5-year survival: 91.9% vs. 67.1%, 77.0%, respectively). For the non-PEA (BPA+medication) strategy, group 3 had better disease-specific survival than groups 1 and 2 (5-year survival: 94.9% vs. 54.6%, 74.2%, respectively). The PEA strategy had significantly better survival than the medication strategy in groups 1 and 2, whereas no difference was observed between the BPA, PEA, and medication strategies in group 3. CONCLUSIONS: Survival in CTEPH in the recent era has significantly improved, especially in non-PEA patients. BPA and selective pulmonary vasodilators could improve survival in the non-PEA group. In the present study, no difference in survival was found between PEA and non-PEA.
Authors: Sylwia Sławek-Szmyt; Aleksander Araszkiewicz; Stanisław Jankiewicz; Marek Grygier; Tatiana Mularek-Kubzdela; Maciej Lesiak Journal: J Clin Med Date: 2022-05-12 Impact factor: 4.964
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Authors: Anna Siennicka; Szymon Darocha; Marta Banaszkiewicz; Piotr Kędzierski; Anna Dobosiewicz; Piotr Błaszczak; Małgorzata Peregud-Pogorzelska; Jarosław Damian Kasprzak; Michał Tomaszewski; Ewa Mroczek; Bożena Zięba; Danuta Karasek; Katarzyna Ptaszyńska-Kopczyńska; Katarzyna Mizia-Stec; Tatiana Mularek-Kubzdela; Anna Doboszyńska; Ewa Lewicka; Marcin Ruchała; Maciej Lewandowski; Sylwia Łukasik; Łukasz Chrzanowski; Dariusz Zieliński; Adam Torbicki; Marcin Kurzyna Journal: Ther Adv Respir Dis Date: 2019 Jan-Dec Impact factor: 4.031