A37-07 Real-world Study of Clinical Characteristics of Patients With Pulmonary Arterial Hypertension

Abstract Rationale Pulmonary hypertension (PH) is classified into five groups. Diagnosis requires multiple tests delaying treatment. This study compared patient and diagnostic characteristics for pulmonary arterial hypertension (PAH; Group 1 PH), Group 2-5 PH, and non-PH using machine-learning in an Electronic Health Record (EHR) dataset. This is novel as prior studies use claims data which may lack hemodynamic parameters. Methods This study analyzed adult patient records from a HIPPA-complaint EHR dataset from Mayo Clinic (2015-2024). Cohort definitions: PAH: right heart catheterization (RHC) data mPAP20 mmHg, PVR2 WU, PCWP≤15 mmHg; ≥2 PAH ICD diagnosis codes or positive natural language processing (NLP) sentiments separated by ≥ 30 days; and use of at least one PAH medication within six months after index date. Group 2-5 PH: RHC (mPAP20mmHg) and ICD codes or positive NLP sentiment separated by ≥ 30 days for corresponding PH subtype. Non-PH: mPAP ≤ 20 mmHg and/or TRV ≤ 2.8 m/s. Index was the earliest NLP or ICD for PAH, earliest RHC for group 2-5 PH and most recent TRV/ mPAP for the non-PH cohort. Clinical variables were analyzed one-year before study index acknowledging data missingness as a limitation of retrospective dataset studies. Results 593 PAH, 817 Group 2-5 PH (67% with group 2 PH), and 11,600 non-PH patients (1:10 propensity-matched) were identified. Age, race, and symptoms were similar across cohorts. PAH had the highest proportion of females (60%) Group 2-5 PH (50%) and non-PH cohort (53%). Clinical characteristic comparison is presented in Table 1. Comorbidities differed across cohorts. RHC: As expected, compared to Group 2-5, the PAH cohort had higher mPAP and PVR and lower PCWP. confirming a distinctly pre-capillary profile. ECHO: Compared to Group 2-5 PH, the PAH cohort had more pronounced right ventricular (RV) pressure overload and dysfunction and more impaired RV longitudinal strain, while TAPSE was similar. At the same time, left heart structure was less affected in PAH compared to Group 2-5. Among laboratory tests, serum creatinine was higher in Group 2-5 and ANA was higher in PAH cohort. Compared to the no-PH cohort, PAH and Group 2-5 cohorts exhibited clinically non-normal RHC and ECHO findings. Conclusion Although symptoms and demographic characteristics were similar among patients with and without PAH, unique RHC, ECHO, laboratory profiles and comorbidities differentiated PAH patients. Screening techniques using these distinct profiles could be considered to facilitate earlier diagnosis and treatment of PAH in clinical settings. This abstract is funded by: Merck & Co., Inc., Rahway, NJ, USA