Elderly patients diagnosed with idiopathic pulmonary arterial hypertension
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Elderly patients diagnosed with idiopathic pulmonary arterial hypertension : results from the COMPERA registry. / Hoeper, Marius M; Huscher, Doerte; Ghofrani, H Ardeschir; Delcroix, Marion; Distler, Oliver; Schweiger, Christian; Grunig, Ekkehard; Staehler, Gerd; Rosenkranz, Stephan; Halank, Michael; Held, Matthias; Grohé, Christian; Lange, Tobias J; Behr, Juergen; Klose, Hans; Wilkens, Heinrike; Filusch, Arthur; Germann, Martin; Ewert, Ralf; Seyfarth, Hans-Juergen; Olsson, Karen M; Opitz, Christian F; Gaine, Sean P; Vizza, C Dario; Vonk-Noordegraaf, Anton; Kaemmerer, Harald; Gibbs, J Simon R; Pittrow, David.
in: INT J CARDIOL, Jahrgang 168, Nr. 2, 30.09.2013, S. 871-80.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Elderly patients diagnosed with idiopathic pulmonary arterial hypertension
T2 - results from the COMPERA registry
AU - Hoeper, Marius M
AU - Huscher, Doerte
AU - Ghofrani, H Ardeschir
AU - Delcroix, Marion
AU - Distler, Oliver
AU - Schweiger, Christian
AU - Grunig, Ekkehard
AU - Staehler, Gerd
AU - Rosenkranz, Stephan
AU - Halank, Michael
AU - Held, Matthias
AU - Grohé, Christian
AU - Lange, Tobias J
AU - Behr, Juergen
AU - Klose, Hans
AU - Wilkens, Heinrike
AU - Filusch, Arthur
AU - Germann, Martin
AU - Ewert, Ralf
AU - Seyfarth, Hans-Juergen
AU - Olsson, Karen M
AU - Opitz, Christian F
AU - Gaine, Sean P
AU - Vizza, C Dario
AU - Vonk-Noordegraaf, Anton
AU - Kaemmerer, Harald
AU - Gibbs, J Simon R
AU - Pittrow, David
N1 - Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
PY - 2013/9/30
Y1 - 2013/9/30
N2 - BACKGROUND: Originally reported to occur predominantly in younger women, idiopathic pulmonary arterial hypertension (IPAH) is increasingly diagnosed in elderly patients. We aimed to describe the characteristics of such patients and their survival under clinical practice conditions.METHODS: Prospective registry in 28 centers in 6 European countries. Demographics, clinical characteristics, hemodynamics, treatment patterns and outcomes of younger (18-65 years) and elderly (>65 years) patients with newly diagnosed IPAH (incident cases only) were compared.RESULTS: A total of 587 patients were eligible for analysis. The median (interquartile, [IQR]) age at diagnosis was 71 (16) years. Younger patients (n=209; median age, 54 [16] years) showed a female-to-male ratio of 2.3:1 whereas the gender ratio in elderly patients (n=378; median age, 75 [8] years) was almost even (1.2:1). Combinations of PAH drugs were widely used in both populations, albeit less frequently in older patients. Elderly patients were less likely to reach current treatment targets (6 min walking distance>400 m, functional class I or II). The survival rates 1, 2, and 3 years after the diagnosis of IPAH were lower in elderly patients, even when adjusted for age- and gender-matched survival tables of the general population (p=0.006 by log-rank analysis).CONCLUSIONS: In countries with an aging population, IPAH is now frequently diagnosed in elderly patients. Compared to younger patients, elderly patients present with a balanced gender ratio and different clinical features, respond less well to medical therapy and have a higher age-adjusted mortality. Further characterization of these patients is required. Clinical trials registration: NCT01347216.
AB - BACKGROUND: Originally reported to occur predominantly in younger women, idiopathic pulmonary arterial hypertension (IPAH) is increasingly diagnosed in elderly patients. We aimed to describe the characteristics of such patients and their survival under clinical practice conditions.METHODS: Prospective registry in 28 centers in 6 European countries. Demographics, clinical characteristics, hemodynamics, treatment patterns and outcomes of younger (18-65 years) and elderly (>65 years) patients with newly diagnosed IPAH (incident cases only) were compared.RESULTS: A total of 587 patients were eligible for analysis. The median (interquartile, [IQR]) age at diagnosis was 71 (16) years. Younger patients (n=209; median age, 54 [16] years) showed a female-to-male ratio of 2.3:1 whereas the gender ratio in elderly patients (n=378; median age, 75 [8] years) was almost even (1.2:1). Combinations of PAH drugs were widely used in both populations, albeit less frequently in older patients. Elderly patients were less likely to reach current treatment targets (6 min walking distance>400 m, functional class I or II). The survival rates 1, 2, and 3 years after the diagnosis of IPAH were lower in elderly patients, even when adjusted for age- and gender-matched survival tables of the general population (p=0.006 by log-rank analysis).CONCLUSIONS: In countries with an aging population, IPAH is now frequently diagnosed in elderly patients. Compared to younger patients, elderly patients present with a balanced gender ratio and different clinical features, respond less well to medical therapy and have a higher age-adjusted mortality. Further characterization of these patients is required. Clinical trials registration: NCT01347216.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Female
KW - Humans
KW - Hypertension, Pulmonary
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Registries
KW - Survival Rate
U2 - 10.1016/j.ijcard.2012.10.026
DO - 10.1016/j.ijcard.2012.10.026
M3 - SCORING: Journal article
C2 - 23164592
VL - 168
SP - 871
EP - 880
JO - INT J CARDIOL
JF - INT J CARDIOL
SN - 0167-5273
IS - 2
ER -