医学
内科学
肺动脉高压
心脏病学
经皮
危险系数
动脉炎
血管成形术
比例危险模型
队列
外科
置信区间
作者
Yu‐Ping Zhou,Yun‐Peng Wei,Yujun Yang,Xiequn Xu,Tao Cheng Wu,Chao Liu,Ke‐Yi Mei,Fuhua Peng,Haiping Wang,Kening Sun,Jingyi Li,Hui‐Fang Wang,Mengtao Li,Duolao Wang,Qi Miao,Xin Jiang,Zhi‐Cheng Jing
标识
DOI:10.1016/j.jacc.2022.01.052
摘要
Percutaneous transluminal pulmonary angioplasty (PTPA) is a treatment modality for chronic thromboembolic pulmonary hypertension, but whether it can be applied to Takayasu arteritis-associated pulmonary hypertension (TA-PH), another chronic obstructive pulmonary vascular disease, remains unclear.This study sought to investigate the efficacy and safety of PTPA for TA-PH.Between January 1, 2016, and December 31, 2019, a total of 50 patients with TA-PH who completed the PTPA procedure (the PTPA group) and 21 patients who refused the PTPA procedure (the non-PTPA group) were prospectively enrolled in this cohort study. The primary outcome was all-cause mortality. The safety outcomes included PTPA procedure-related complications.Baseline characteristics and medical therapies were similar between the PTPA group and the non-PTPA group. During a mean follow-up time of 37 ± 14 months, deaths occurred in 3 patients (6.0%) in the PTPA group and 6 patients (28.6%) in the non-PTPA group, contributing to the 3-year survival rate of 93.7% in the PTPA group and 76.2% in the non-PTPA group (P = 0.0096 for log-rank test). The Cox regression model showed that PTPA was associated with a significantly reduced hazard of all-cause mortality in TA-PH patients (HR: 0.18; 95% CI: 0.05-0.73; P = 0.017). No periprocedural death occurred. Severe complications requiring noninvasive positive pressure ventilation occurred in only 1 of 150 total sessions (0.7%).PTPA tended to be associated with a reduced risk of all-cause mortality with acceptable safety profiles and seemed to be a promising therapeutic option for TA-PH patients.
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