Chest
Original ResearchPulmonary Vascular DiseaseDelay in Recognition of Pulmonary Arterial Hypertension: Factors Identified From the REVEAL Registry
Section snippets
Design Overview
We conducted a cohort study among patients enrolled in the REVEAL Registry between March 1, 2006, and September 30, 2007. The study was approved by the institutional review board at each participating center (e-Appendix 1). Subjects provided written informed consent for collection of baseline and follow-up data. The design of the REVEAL Registry has been described in detail previously.20 Briefly, patients with PAH who were either previously diagnosed or newly diagnosed (defined as having a
Results
Of the 2,967 patients with PAH enrolled in the REVEAL Registry (Fig 1), we excluded 200 patients younger than 19 years at the time of diagnostic RHC. A total of 242 patients (8.2% of the enrolled population) had a PCWP or LVEDP > 15 to ≤ 18 mm Hg. A total of 2,525 patients met the conventional hemodynamic criteria for PAH. Thirty-two of these patients were excluded because of a missing date of PAH symptom onset. The final study population consisted of 2,493 patients, of whom 526 (21.1%) had
Discussion
Hemodynamic measurements are required to make a diagnosis of PAH.24 However, the REVEAL Registry is designed to capture “real-world” clinical practice where patients, ultimately having a valid diagnosis of PAH, may be told of a diagnosis of PAH, or started on PAH-specific therapy prior to the performance of the RHC that qualified them for the REVEAL Registry. This may have been due to an incomplete assessment of PAH, but occasionally the hemodynamic parameters required for REVEAL Registry entry
Acknowledgments
Author contributions: Dr Brown: contributed to the study design; collection, analysis and interpretation of data; drafting and critical review of the manuscript; and has seen and approved the final version.
Dr Chen: contributed to the study design; collection, analysis and interpretation of data; drafting and critical review of the manuscript; and has seen and approved the final version.
Dr Halpern: contributed to the study design; collection, analysis and interpretation of data; drafting and
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Cited by (0)
Funding/Support: The REVEAL Registry is sponsored by Actelion Pharmaceuticals US, Inc.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).