Key result
Cardiologists manage primary PAH ~56% more frequently than pulmonologists, favoring initial monotherapy.
Why the study?
Accurate management of PAH is necessary to decrease morbidity and mortality, making it important to understand current practices and perspectives on PAH.
Cross-Sectional (n=200)
In Turkey, cardiologists are more frequently involved in the primary diagnosis and treatment of PAH than pulmonologists, with overall clinical management complying with guideline recommendations.
Answers are grounded in this paper and cite their sources.
PAH care in Turkey aligns with guidelines; leaves open questions on outcomes and broader adoption.
Background and Objectives: Pulmonary arterial hypertension (PAH) is a rare chronic disease of the small pulmonary arteries that causes right heart failure and death. Accurate management of PAH is necessary to decrease morbidity and mortality. Understanding current practices and perspectives on PAH is important. For this purpose, we intended to determine physicians’ knowledge, attitudes, and practice patterns in adult pulmonary arterial hypertension (PAH) in Turkey. Materials and Methods: Between January and February 2022, an online questionnaire was sent via e-mail to all cardiologists and pulmonologists who were members of the Turkish Society of Cardiology (TSC) and the Turkish Thoracic Society (TTS). Results: A total of 200 physicians (122 pulmonologists and 78 cardiologists) responded to the questionnaire. Cardiologists were more frequently involved in the primary diagnosis and treatment of PAH than pulmonologists (37.2% vs. 23.8%, p = 0.042). More than half of the physicians had access to right heart catheterization. In mild/moderate PAH patients with a negative vasoreactivity test, the monotherapy option was most preferred (82.8%) and endothelin receptor antagonists (ERAs) were the most preferred group in these patients (73%). ERAs plus phosphodiesterase-5 inhibitors (PDE-5 INH) were the most preferred (69%) combination therapy, and prostacyclin analogues plus PDE-5 INH was preferred by only pulmonologists. Conclusions: Overall, clinical management of patients with PAH complied with guideline recommendations. Effective clinical management of PAH in specialized centers that having right heart catheterization achieve better outcomes.
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Günaydın et al. (2023) conducted a cross-sectional in Pulmonary Arterial Hypertension (PAH) management (n=200). Cardiology specialty vs. Pulmonology specialty was evaluated on Involvement in the primary diagnosis and treatment of PAH (p=0.042). Cardiologists were more frequently involved in the primary diagnosis and treatment of PAH than pulmonologists (37.2% vs. 23.8%, p = 0.042), with monotherapy being the preferred initial treatment.
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