CLINICAL CHARACTERISTICS AND LONG-TERM SURVIVAL OF CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION (CTEPH) PATIENTS TREATED WITH MULTIMODAL THERAPY - DATA FROM NATIONWIDE DATABASE
Tématický okruh: Plicní hypertenze | |
| Typ: Ústní sdělení - lékařské , Číslo v programu: 66 | |
| Přihlášeno do: Soutěž mladých kardiologů | |
| Miksová L.1, Svoboda M.2, Dytrych V.3, Širanec M.3, Rajčinova M.3, Heller S.3, Paďour M.3, Ambrož D.3, Aschermann M.3, Prskavec T.4, Nižnanský M.4, Lindner J.4, Grus T.4, Linhart A.3, Jansa P.3 1 II. interní klinika kardiologie a angiologie, Všeobecná fakultní nemocnice v Praze, Prague, 2 Data Analysis Department, Institute of Biostatistics and Analyses, Brno, 3 2nd Department of Medicine - Clinical Department of Cardiology and Angiology, General University Hospital in Prague, Prague, 4 2nd Department of Surgery - Department of Cardiovascular Surgery, General University Hospital in Prague, Prague | |
Introduction: CTEPH is a rare complication of acute pulmonary embolism. Management of CTEPH has significantly changed and is now multimodal with an individualized combination of pulmonary endarterectomy (PEA), balloon pulmonary angioplasty (BPA) and medical therapy. Aim: We report clinical characteristics and survival of all adult CTEPH patients diagnosed between 2017–2022 in the Czech Republic. Methodology: All newly diagnosed CTEPH patients have been treated based on a multidisciplinary team discussion. Survival from diagnosis was calculated using Kaplan-Meier estimates. Data have been descriptively compared with the historical CTEPH cohort (patients diagnosed between 2003 and 2016 when the main treatment option was limited to surgery). Results: Characteristics of patients (N=321) at diagnosis when compared with the historical cohort were: median age of 66.9 vs 65.2 years, 53% vs 55% male, NYHA functional class III–IV 80% vs 92%, median 6-minute walk distance 404 vs 336 m, median time from 1st pulmonary embolism to CTEPH diagnosis 1 vs 2.2 years. Median time from diagnosis to the last follow-up was 2.4 years. 114 (36%) patients benefitted from PEA. At least one session of BPA was performed in 94 not operated patients, in 60 patients in combination with medical therapy. Prevalence of comorbidities was: cancer 11.6 % diabetes 20.9%, COPD 21.6%, sleep apnoea 19.7%, arterial hypertension 66.9%, atrial fibrillation 17.8 %, atrial flutter 6.2 %, ischemic heart disease 17.2 %. The 3-year survival was 80 % for overall, 88% for operated, 75 % for not operated. Conclusion: These data indicate a shortening of time to CTEPH diagnosis and a high prevalence of comorbidities affecting mainly the survival of not operated patients in the CTEPH multimodal therapy era. | |
