Risk assessment in pulmonary hypertension based on routinely measured laboratory parameters

Athiththan Yogeswaran; Khodr Tello; Jonas Lund; Hans Klose; Lars Harbaum; Natascha Sommer; Tim Oqueka; Jan K Hennigs; Friedrich Grimminger; Werner Seeger; Hossein Ardeschir Ghofrani; Manuel J Richter; Henning Gall

doi:10.1016/j.healun.2021.10.018

Risk assessment in pulmonary hypertension based on routinely measured laboratory parameters

Standard

Risk assessment in pulmonary hypertension based on routinely measured laboratory parameters. / Yogeswaran, Athiththan; Tello, Khodr; Lund, Jonas; Klose, Hans ; Harbaum, Lars; Sommer, Natascha; Oqueka, Tim ; Hennigs, Jan K; Grimminger, Friedrich; Seeger, Werner; Ghofrani, Hossein Ardeschir; Richter, Manuel J; Gall, Henning.

In: J HEART LUNG TRANSPL, Vol. 41, No. 3, 03.2022, p. 400-410.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Yogeswaran, A, Tello, K, Lund, J, Klose, H , Harbaum, L, Sommer, N, Oqueka, T , Hennigs, JK, Grimminger, F, Seeger, W, Ghofrani, HA, Richter, MJ & Gall, H 2022, 'Risk assessment in pulmonary hypertension based on routinely measured laboratory parameters', J HEART LUNG TRANSPL, vol. 41, no. 3, pp. 400-410. https://doi.org/10.1016/j.healun.2021.10.018

APA

Yogeswaran, A., Tello, K., Lund, J., Klose, H., Harbaum, L., Sommer, N., Oqueka, T., Hennigs, J. K., Grimminger, F., Seeger, W., Ghofrani, H. A., Richter, M. J., & Gall, H. (2022). Risk assessment in pulmonary hypertension based on routinely measured laboratory parameters. J HEART LUNG TRANSPL, 41(3), 400-410. https://doi.org/10.1016/j.healun.2021.10.018

Vancouver

Yogeswaran A, Tello K, Lund J, Klose H , Harbaum L, Sommer N et al. Risk assessment in pulmonary hypertension based on routinely measured laboratory parameters. J HEART LUNG TRANSPL. 2022 Mar;41(3):400-410. https://doi.org/10.1016/j.healun.2021.10.018

Bibtex

@article{725347d7328443df93f8c6128e04afef,

title = "Risk assessment in pulmonary hypertension based on routinely measured laboratory parameters",

abstract = "BACKGROUND: γ-glutamyl transferase (GGT), the aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio, and the neutrophil-to-lymphocyte ratio (NLR) are prognostic biomarkers in several cardiovascular diseases, but their relevance in pulmonary hypertension (PH) is not fully understood. We aimed to assess their prognostic value in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic PH (CTEPH).METHODS: We retrospectively analyzed 731 incident patients with idiopathic PAH or CTEPH who entered the Giessen PH registry during 1993-2019. A risk stratification score based on GGT, AST/ALT ratio, and NLR tertiles was compared with a truncated version of the European Society of Cardiology/European Respiratory Society (ESC/ERS) risk stratification scheme. Associations with survival were evaluated using Kaplan-Meier and Cox regression analyses. External validation was performed in 311 patients with various types of PAH or CTEPH from a second German center.RESULTS: GGT levels, AST/ALT, and NLR independently predicted mortality at baseline and during follow-up. The scoring system based on these biomarkers predicted mortality at baseline and during follow-up (both log-rank p < 0.001; hazard ratio [95% confidence interval], high vs low risk: baseline, 7.6 [3.9, 15.0]; follow-up, 13.3 [4.8, 37.1]). Five-year survival of low, intermediate, and high risk groups was 92%, 76%, and 51%, respectively, at baseline and 95%, 78%, and 50%, respectively, during follow-up. Our scoring system showed characteristics comparable to the ESC/ERS scheme, and predicted mortality in the validation cohort.CONCLUSION: GGT, AST/ALT, and NLR were reliable prognostic biomarkers at baseline and during follow-up, with predictive power comparable to the gold standard for risk stratification.",

author = "Athiththan Yogeswaran and Khodr Tello and Jonas Lund and Hans Klose and Lars Harbaum and Natascha Sommer and Tim Oqueka and Hennigs, {Jan K} and Friedrich Grimminger and Werner Seeger and Ghofrani, {Hossein Ardeschir} and Richter, {Manuel J} and Henning Gall",

year = "2022",

month = mar,

doi = "10.1016/j.healun.2021.10.018",

language = "English",

volume = "41",

pages = "400--410",

journal = "J HEART LUNG TRANSPL",

issn = "1053-2498",

publisher = "Elsevier USA",

number = "3",

}

RIS

TY - JOUR

T1 - Risk assessment in pulmonary hypertension based on routinely measured laboratory parameters

AU - Yogeswaran, Athiththan

AU - Tello, Khodr

AU - Lund, Jonas

AU - Klose, Hans

AU - Harbaum, Lars

AU - Sommer, Natascha

AU - Oqueka, Tim

AU - Hennigs, Jan K

AU - Grimminger, Friedrich

AU - Seeger, Werner

AU - Ghofrani, Hossein Ardeschir

AU - Richter, Manuel J

AU - Gall, Henning

PY - 2022/3

Y1 - 2022/3

N2 - BACKGROUND: γ-glutamyl transferase (GGT), the aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio, and the neutrophil-to-lymphocyte ratio (NLR) are prognostic biomarkers in several cardiovascular diseases, but their relevance in pulmonary hypertension (PH) is not fully understood. We aimed to assess their prognostic value in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic PH (CTEPH).METHODS: We retrospectively analyzed 731 incident patients with idiopathic PAH or CTEPH who entered the Giessen PH registry during 1993-2019. A risk stratification score based on GGT, AST/ALT ratio, and NLR tertiles was compared with a truncated version of the European Society of Cardiology/European Respiratory Society (ESC/ERS) risk stratification scheme. Associations with survival were evaluated using Kaplan-Meier and Cox regression analyses. External validation was performed in 311 patients with various types of PAH or CTEPH from a second German center.RESULTS: GGT levels, AST/ALT, and NLR independently predicted mortality at baseline and during follow-up. The scoring system based on these biomarkers predicted mortality at baseline and during follow-up (both log-rank p < 0.001; hazard ratio [95% confidence interval], high vs low risk: baseline, 7.6 [3.9, 15.0]; follow-up, 13.3 [4.8, 37.1]). Five-year survival of low, intermediate, and high risk groups was 92%, 76%, and 51%, respectively, at baseline and 95%, 78%, and 50%, respectively, during follow-up. Our scoring system showed characteristics comparable to the ESC/ERS scheme, and predicted mortality in the validation cohort.CONCLUSION: GGT, AST/ALT, and NLR were reliable prognostic biomarkers at baseline and during follow-up, with predictive power comparable to the gold standard for risk stratification.

AB - BACKGROUND: γ-glutamyl transferase (GGT), the aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio, and the neutrophil-to-lymphocyte ratio (NLR) are prognostic biomarkers in several cardiovascular diseases, but their relevance in pulmonary hypertension (PH) is not fully understood. We aimed to assess their prognostic value in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic PH (CTEPH).METHODS: We retrospectively analyzed 731 incident patients with idiopathic PAH or CTEPH who entered the Giessen PH registry during 1993-2019. A risk stratification score based on GGT, AST/ALT ratio, and NLR tertiles was compared with a truncated version of the European Society of Cardiology/European Respiratory Society (ESC/ERS) risk stratification scheme. Associations with survival were evaluated using Kaplan-Meier and Cox regression analyses. External validation was performed in 311 patients with various types of PAH or CTEPH from a second German center.RESULTS: GGT levels, AST/ALT, and NLR independently predicted mortality at baseline and during follow-up. The scoring system based on these biomarkers predicted mortality at baseline and during follow-up (both log-rank p < 0.001; hazard ratio [95% confidence interval], high vs low risk: baseline, 7.6 [3.9, 15.0]; follow-up, 13.3 [4.8, 37.1]). Five-year survival of low, intermediate, and high risk groups was 92%, 76%, and 51%, respectively, at baseline and 95%, 78%, and 50%, respectively, during follow-up. Our scoring system showed characteristics comparable to the ESC/ERS scheme, and predicted mortality in the validation cohort.CONCLUSION: GGT, AST/ALT, and NLR were reliable prognostic biomarkers at baseline and during follow-up, with predictive power comparable to the gold standard for risk stratification.

U2 - 10.1016/j.healun.2021.10.018

DO - 10.1016/j.healun.2021.10.018

M3 - SCORING: Journal article

C2 - 34857454

VL - 41

SP - 400

EP - 410

JO - J HEART LUNG TRANSPL

JF - J HEART LUNG TRANSPL

SN - 1053-2498

IS - 3

ER -