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J Am Coll Cardiol. 2012 Sep 25;60(13):1192-201. doi: 10.1016/j.jacc.2012.01.083.

Do changes of 6-minute walk distance predict clinical events in patients with pulmonary arterial hypertension? A meta-analysis of 22 randomized trials.

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1
Department of Internal Medicine, Cardiovascular Sciences and Immunology, Federico II University, Via Pansini 5, Naples, Italy.

Abstract

OBJECTIVES:

The objectives of this study were to verify whether improvement in 6-min walk distance (6MWD) is associated with clinical outcome in pulmonary arterial hypertension (PAH).

BACKGROUND:

6MWD is used as an endpoint to assess the benefit of therapies in PAH. However, whether changes in 6MWD correlate with clinical outcome is unknown.

METHODS:

Randomized trials assessing 6MWD in patients with PAH and reporting clinical endpoints were included in a meta-analysis. The meta-analysis was performed to assess the influence of treatment on outcomes. Meta-regression analysis was performed to test the relationship between 6MWD changes and outcomes.

RESULTS:

Twenty-two trials enrolling 3,112 participants were included. Active treatments led to significant reduction of all-cause death (odds ratio [OR]: 0.429; 95% confidence interval [CI]: 0.277 to 0.664; p < 0.01), hospitalization for PAH, and/or lung or heart-lung transplantation (OR: 0.442; 95% CI: 0.309 to 0.632; p < 0.01), initiation of PAH rescue therapy (OR: 0.555; 95% CI: 0.347 to 0.889; p = 0.01), and composite outcome (OR: 0.400; 95% CI: 0.313 to 0.510; p < 0.01). No relationship between 6MWD changes and outcomes was detected.

CONCLUSIONS:

In patients with PAH, improvement in 6MWD does not reflect benefit in clinical outcomes.

PMID:
22995024
DOI:
10.1016/j.jacc.2012.01.083
[Indexed for MEDLINE]
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