Survival trends in patients with chronic thromboembolic pulmonary hypertension: An observational study.

IF 16.6 1区医学 Q1 RESPIRATORY SYSTEM

European Respiratory Journal Pub Date : 2025-03-06 DOI:10.1183/13993003.02268-2024

Takatoyo Kiko, Ryotaro Asano, Yusuke Yoshikawa, Hiroyuki Endo, Shinya Fujisaki, Ryo Takano, Mitsumasa Akao, Naruhiro Nishi, Hiroya Hayashi, Soshiro Ogata, Akiyuki Kotoku, Hiroki Horinouchi, Yosuke Inoue, Jin Ueda, Yoshimasa Seike, Akihiro Tsuji, Tetsuya Fukuda, Kunihiro Nishimura, Hitoshi Matsuda, Takeshi Ogo

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Abstract

Background: Treatment options for patients with chronic thromboembolic hypertension (CTEPH) have increased over the past decade. However, it is unknown whether the outcomes of patients with CTEPH have changed as well.

Methods: This retrospective study analysed the data of 834 patients with CTEPH, categorised into early (April 1980-December 1999), middle (January 2000-September 2010), and current (October 2010-December 2023) eras. The primary endpoint was all-cause mortality. Multivariable Cox proportional hazards models were used to assess changes in all-cause mortality after adjusting for confounding variables.

Results: Ninety-five, 210, and 529 patients were from the early, middle, and current eras, respectively. The proportion of patients who did not receive CTEPH therapy decreased from 65% in the early era to 36% and 3% in the middle and current eras, respectively. Meanwhile, the adoption of multimodal treatment increased from 0% to 58% over time. The Kaplan-Meier analysis revealed significant improvements in overall survival (log-rank p<0.001). The 5-year survival rates improved from 68% in the early era to 85% and 93% in the middle and current eras, respectively. The adjusted hazard ratios for mortality were 0.291 (95% confidence interval [CI]: 0.154-0.550; p<0.001) for the early versus middle era, 0.447 (95% CI: 0.249-0.804; p=0.007) for the middle versus current era, and 0.130 (95% CI: 0.067-0.254; p<0.001) for the early versus current era.

Conclusions: The long-term prognosis of patients with CTEPH has significantly improved in recent decades.

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慢性血栓栓塞性肺动脉高压患者的生存趋势：一项观察性研究。

背景：慢性血栓栓塞性高血压（CTEPH）患者的治疗选择在过去十年中有所增加。然而，尚不清楚CTEPH患者的预后是否也发生了变化。方法：回顾性分析834例CTEPH患者的资料，分为早期（1980年4月- 1999年12月）、中期（2000年1月- 2010年9月）和当前（2010年10月- 2023年12月）。主要终点是全因死亡率。多变量Cox比例风险模型用于评估在调整混杂变量后全因死亡率的变化。结果：早期95例，中期210例，当代529例。未接受CTEPH治疗的患者比例分别从早期的65%下降到中期和当前的36%和3%。同时，随着时间的推移，多模式治疗的采用从0%增加到58%。Kaplan-Meier分析显示总生存率显著改善（log-rank ppvs .中期，0.447）(95% CI: 0.249-0.804；p=0.007)和0.130 (95% CI: 0.067-0.254；相对于当前时代。结论：近几十年来，CTEPH患者的长期预后有明显改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Respiratory Journal 医学-呼吸系统

CiteScore

27.50

自引率

3.30%

发文量

345

审稿时长

2-4 weeks

期刊介绍： The European Respiratory Journal (ERJ) is the flagship journal of the European Respiratory Society. It has a current impact factor of 24.9. The journal covers various aspects of adult and paediatric respiratory medicine, including cell biology, epidemiology, immunology, oncology, pathophysiology, imaging, occupational medicine, intensive care, sleep medicine, and thoracic surgery. In addition to original research material, the ERJ publishes editorial commentaries, reviews, short research letters, and correspondence to the editor. The articles are published continuously and collected into 12 monthly issues in two volumes per year.