Latin American patients with pulmonary arterial hypertension achieved a 3-year survival rate of 83.0% (95% CI 81.2-84.7), which was comparable to other developing-country registries.
Meta-Analysis (n=2,461)
Yes
Patients with PAH in Latin America achieve survival outcomes comparable to other developing-country registries, with younger age and more recent enrollment associated with better survival.
Abstract Rationale Pulmonary arterial hypertension (PAH) is a progressive disease with high mortality. Large international registries have provided detailed outcome data, but data from Latin America and the Caribbean (LAC) remains fragmented. Understanding how LAC and international registries compare is critical for identifying disparities and variability in PAH care. We pooled LAC registry-level data in a large meta-analysis and compared survival with major international registries, and examined the effects of age and registry enrollment mid-point on survival. Methods We identified PAH registries and cohorts from Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Peru, and Uruguay spanning 1999-2025 (16 studies, 2,461 patients). Major international comparators included REVEAL, PHAR, COMPERA, and other registries. Extracted study-level variables included mean age, sex, WHO functional class (FC III-IV), 6-minute walk distance (6MWT), PAH etiology, and 1-, 2-, and 3-year survival with 95% confidence intervals. Survival data were pooled using a meta-analysis of proportions, and meta-regression was performed to assess the relationship between mean age, registry enrollment mid-point, and survival. Results Latin American patients were younger (mean 43.6 ± 12 years) and predominantly female (81.5%) compared to other developing-country registries (Fig. 1). Advanced functional class (FC III-IV) was observed in 51% of patients, and CHD-PAH prevalence was high (25.6%). Meta-analysis showed 1-, 2-, and 3-year survival in LAC of 93.9% (95% CI 92.7-95.0), 87.5% (95% CI 85.8-89.0), and 83.0% (95% CI 81.2-84.7), respectively, comparable to Chinese, Saudi Arabian, Korean, and Australia/New Zealand registries. Meta-regression across all registries demonstrated that older mean age predicted lower survival at 1, 2, and 3 years (p 0.01), while more recent registry enrollment predicted improved outcomes independent of age (p 0.01). Adding functional class and 6MWT did not significantly alter the model. Conclusions This meta-analysis shows that patients with PAH in LAC achieve survival outcomes comparable to those in other developing-country registries. Younger age and more recent registry enrollment were associated with better survival, reflecting improvements in PAH care in the modern era. Further harmonization of comorbidity and treatment data is needed to refine these comparisons. These findings highlight the importance of accounting for regional epidemiologic differences to ensure equitable representation in global PAH research and caution that favorable survival may partly reflect the younger age at registry enrollment. This abstract is funded by: None
Garcia et al. (Fri,) conducted a meta-analysis in Pulmonary arterial hypertension (PAH) (n=2,461). Latin American and Caribbean (LAC) registries vs. International registries was evaluated on 3-year survival (95% CI 81.2-84.7). Latin American patients with pulmonary arterial hypertension achieved a 3-year survival rate of 83.0% (95% CI 81.2-84.7), which was comparable to other developing-country registries.