Characteristics and long-term survival of patients with chronic thromboembolic pulmonary hypertension in China

Respirology. 2021 Feb;26(2):196-203. doi: 10.1111/resp.13947. Epub 2020 Sep 20.

Abstract

Background and objective: The purpose of this study was to report the characteristics and long-term survival of patients with CTEPH treated in three distinct ways: PEA, BPA and medical therapy.

Methods: Patients diagnosed with CTEPH were included in the registry that was set up in 18 centres from August 2009 to July 2018. The characteristics and survival of patients with CTEPH receiving the different treatments were reported. Prognostic factors were evaluated by Cox regression model.

Results: A total of 593 patients with CTEPH were included. Eighty-one patients were treated with PEA, 61 with BPA and 451 with drugs. The estimated survival rates at 1, 3, 5 and 8 years were, respectively, 95.2%, 84.6%, 73.4% and 66.6% in all patients; 92.6%, 89.6%, 87.5% and 80.2% in surgical patients; and 95.4%, 88.3%, 71.0% and 64.1% in medically treated patients. The estimated survival rates at 1, 3, 5 and 7 years in patients treated with BPA were 96.7%, 88.1%, 70.0% and 70.0%, respectively. For all patients, PEA was an independent predictor of survival. Other independent risk factors were CHD, cardiac index, PVR, big endothelin-1, APE and 6MWD.

Conclusion: This is the first multicentre prospective registry reporting baseline characteristics and estimated survival of patients with CTEPH in China. The long-term survival rates are similar to those of patients in the international and Spanish registries. PEA is an independent predictor of survival.

Trial registration: ClinicalTrials.gov NCT01417338.

Keywords: balloon pulmonary angioplasty; chronic thromboembolic pulmonary hypertension; pulmonary endarterectomy; survival.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angioplasty, Balloon
  • China
  • Chronic Disease
  • Endarterectomy
  • Endothelin-1 / metabolism
  • Female
  • Humans
  • Hypertension, Pulmonary / complications*
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / mortality*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pulmonary Embolism / complications*
  • Pulmonary Embolism / mortality*
  • Pulmonary Embolism / surgery
  • Registries
  • Risk Factors
  • Survival Analysis
  • Time Factors
  • Treatment Outcome

Substances

  • Endothelin-1

Associated data

  • ClinicalTrials.gov/NCT01417338