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Impact of age and comorbidity on risk stratification in idiopathic pulmonary arterial hypertension
Sahlgrens Univ Hosp, Sweden; Gothenburg Univ, Sweden.
Skane Univ Hosp, Sweden; Lund Univ, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping.
Sahlgrens Univ Hosp, Sweden; Gothenburg Univ, Sweden.
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2018 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 51, no 5, article id 1702310Article in journal (Refereed) Published
Abstract [en]

Recent reports from worldwide pulmonary hypertension registries show a new demographic picture for patients with idiopathic pulmonary arterial hypertension (IPAH), with an increasing prevalence among the elderly. We aimed to investigate the effects of age and comorbidity on risk stratification and outcome of patients with incident IPAH. The study population (n=264) was categorised into four age groups: 18-45, 46-64, 65-74 and amp;gt;= 75 years. Individual risk profiles were determined according to a risk assessment instrument, based on the European Society of Cardiology and the European Respiratory Society guidelines. The change in risk group from baseline to follow-up (median 5 months) and survival were compared across age groups. In the two youngest age groups, a significant number of patients improved (18-45 years, Z=-4.613, pamp;lt; 0.001; 46-64 years, Z=-2.125, p=0.034), but no significant improvement was found in the older patient groups. 5-year survival was highest in patients aged 18-45 years (88%), while the survival rates were 63%, 56% and 36% for patients in the groups 46-64, 65-74 and. 75 years, respectively (pamp;lt; 0.001). Ischaemic heart disease and kidney dysfunction independently predicted survival. These findings highlight the importance of age and specific comorbidities as prognostic markers of outcome in addition to established risk assessment algorithms.

Place, publisher, year, edition, pages
EUROPEAN RESPIRATORY SOC JOURNALS LTD , 2018. Vol. 51, no 5, article id 1702310
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Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:liu:diva-149479DOI: 10.1183/13993003.02310-2017ISI: 000435212900011PubMedID: 29622568OAI: oai:DiVA.org:liu-149479DiVA, id: diva2:1231074
Note

Funding Agencies|Actelion Pharmaceuticals Sweden AB; Bayer Health Care; Eli Lilly Sweden; GlaxoSmithKline; NordicInfu Care; Pfizer; Swedish Association of Local Authorities and Regions

Available from: 2018-07-05 Created: 2018-07-05 Last updated: 2018-07-26

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Kylhammar, David
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Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Clinical Physiology in Linköping
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