Universität zu Köln

Vizza, Carmine Dario ORCID: 0000-0002-3540-4983, Hoeper, Marius M., Huscher, Doerte, Pittrow, David, Benjamin, Nicola, Olsson, Karen M., Ghofrani, H. Ardeschir, Held, Matthias, Klose, Hans, Lange, Tobias, Rosenkranz, Stephan, Dumitrescu, Daniel, Badagliacca, Roberto, Claussen, Martin, Halank, Michael, Vonk-Noordegraaf, Anton, Skowasch, Dirk, Ewert, Ralf, Gibbs, J. Simon R., Delcroix, Marion ORCID: 0000-0001-8394-9809, Skride, Andris ORCID: 0000-0002-1087-687X, Coghlan, Gerry, Ulrich, Silvia, Opitz, Christian, Kaemmerer, Harald, Distler, Oliver and Grunig, Ekkehard (2021). Pulmonary Hypertension in Patients With COPD Results From the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA). Chest, 160 (2). S. 678 - 690. AMSTERDAM: ELSEVIER. ISSN 1931-3543

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Abstract

BACKGROUND: Pulmonary hypertension (PH) in COPD is a poorly investigated clinical condition. RESEARCH QUESTION: Which factors determine the outcome of PH in COPD? STUDY DESIGN AND METHODS: We analyzed the characteristics and outcome of patients enrolled in the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA) with moderate or severe PH in COPD as defined during the 6th PH World Symposium who received medical therapy for PH and compared them with patients with idiopathic pulmonary arterial hypertension (IPAH). RESULTS: The population included incident patients with moderate PH in COPD (n = 68), with severe PH in COPD (n = 307), and with IPAH (n = 489). Patients with PH in COPD were older, predominantly male, and treated mainly with phosphodiesterase-5 inhibitors. Despite similar hemodynamic impairment, patients with PH in COPD achieved a worse 6-min walking distance (6MWD) and showed a more advanced World Health Organization functional class (WHO FC). Transplant-free survival rates at 1, 3, and 5 years were higher in the IPAH group than in the PH in COPD group (IPAH: 94%, 75%, and 55% vs PH in COPD: 86%, 55%, and 38%; P = .004). Risk factors for poor outcomes in PH in COPD were male sex, low 6MWD, and high pulmonary vascular resistance (PVR). In patients with severe PH in COPD, improvements in 6MWD by >= 30 m or improvements in WHO FC after initiation of medical therapy were associated with better outcomes. INTERPRETATION: Patients with PH in COPD were functionally more impaired and had a poorer outcome than patients with IPAH. Predictors of death in the PH in COPD group were sex, 6MWD, and PVR. Our data raise the hypothesis that some patients with severe PH in COPD may benefit from PH treatment. Randomized controlled studies are necessary to explore this hypothesis further.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Vizza, Carmine Dario UNSPECIFIED orcid.org/0000-0002-3540-4983 UNSPECIFIED Hoeper, Marius M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Huscher, Doerte UNSPECIFIED UNSPECIFIED UNSPECIFIED Pittrow, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Benjamin, Nicola UNSPECIFIED UNSPECIFIED UNSPECIFIED Olsson, Karen M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ghofrani, H. Ardeschir UNSPECIFIED UNSPECIFIED UNSPECIFIED Held, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Klose, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED Lange, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosenkranz, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Dumitrescu, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Badagliacca, Roberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Claussen, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Halank, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Vonk-Noordegraaf, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Skowasch, Dirk UNSPECIFIED UNSPECIFIED UNSPECIFIED Ewert, Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED Gibbs, J. Simon R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Delcroix, Marion UNSPECIFIED orcid.org/0000-0001-8394-9809 UNSPECIFIED Skride, Andris UNSPECIFIED orcid.org/0000-0002-1087-687X UNSPECIFIED Coghlan, Gerry UNSPECIFIED UNSPECIFIED UNSPECIFIED Ulrich, Silvia UNSPECIFIED UNSPECIFIED UNSPECIFIED Opitz, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaemmerer, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Distler, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Grunig, Ekkehard UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-606670
DOI:	10.1016/j.chest.2021.02.012
Journal or Publication Title:	Chest
Volume:	160
Number:	2
Page Range:	S. 678 - 690
Date:	2021
Publisher:	ELSEVIER
Place of Publication:	AMSTERDAM
ISSN:	1931-3543
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SILDENAFIL; DISEASE; SURVIVAL; OUTCOMES; VOLUME Multiple languages Critical Care Medicine; Respiratory System Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60667