Haemodynamics, exercise capacity and clinical events in pulmonary arterial hypertension
Key result
Pharmacological therapy significantly reduced all-cause death (OR 0.5; 95% CI 0.3-0.7; p<0.01), but haemodynamic improvements did not predict clinical events in short-term follow-up.
Why the study?
Do changes in cardiopulmonary haemodynamics induced by pharmacological therapy correlate with exercise capacity and clinical events in patients with pulmonary arterial hypertension?
Population
2353 patients with pulmonary arterial hypertension (pooled from 16 randomised trials)
Design
Meta-analysis
Follow-up
16.4±10.6 weeks
Authors
Discussion
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Implication
Hemodynamic changes may guide PAH therapy decisions; confirms surrogacy for exercise capacity and events in trials.
Study Design
Type
Meta-Analysis (n=2,353)
Structured PICO
Do changes in cardiopulmonary haemodynamics induced by pharmacological therapy correlate with exercise capacity and clinical events in patients with pulmonary arterial hypertension?
P
Population
2,353 patients with pulmonary arterial hypertension from 16 randomised trials, followed for 16.4±10.6 weeks.
I
Intervention
Pharmacological therapy for pulmonary arterial hypertension
O
Outcome
Correlation between changes in cardiopulmonary haemodynamics (pulmonary artery pressure, pulmonary vascular resistance, cardiac index, right atrial pressure) and clinical events (all-cause death, hospitalisation for pulmonary arterial hypertension, initiation of rescue therapy, composite outcome)composite
Main Result
Odds Ratio: 0.5 (95% CI 0.3–0.7)
p-value: p=<0.01
In patients with pulmonary arterial hypertension, short-term improvements in cardiopulmonary haemodynamics correlate with exercise capacity but fail to predict clinical events.
Cite This Study
Savarese et al. (2012) conducted a meta-analysis in pulmonary arterial hypertension (n=2,353). Pharmacological therapy vs. Control was evaluated on all-cause death (OR 0.5, 95% CI 0.3-0.7, p=<0.01). Pharmacological therapy significantly reduced all-cause death (OR 0.5; 95% CI 0.3-0.7; p<0.01), but haemodynamic improvements did not predict clinical events in short-term follow-up.