Chest
Original ResearchPulmonary Vascular DiseaseDemographics and Outcomes of Patients Diagnosed With Pulmonary Hypertension With Pulmonary Capillary Wedge Pressures 16 to 18 mm Hg: Insights From the REVEAL Registry
Section snippets
Study Design and Population
The registry design and baseline characteristics of patients enrolled in the REVEAL Registry have been described previously.3, 11 The REVEAL Registry is an observational 55-center, prospective, US-based registry designed to provide current information about demographic characteristics, course, and management of 3,518 patients with PAH. The REVEAL protocol was approved by the institutional review board of each study center, and all patients provided written informed consent prior to study entry.
Full-Analysis Cohort
The characteristics of the 3,128 patients who met inclusion criteria at diagnostic RHC (the full-analysis cohort) are presented in Table 1 according to diagnostic PCWP. Compared with patients who had PCWP ≤ 15 mm Hg, patients with PCWP ≥ 16 mm Hg were older (mean, 54 years at diagnosis); more likely to be obese (45% had BMI ≥ 30 kg/m2); more likely to have a history of systemic hypertension (52%); more likely to use statins (20%); and more likely to have diabetes mellitus (20%), renal
Discussion
A threshold PCWP of 15 mm Hg in clinical studies and US Food and Drug Administration-approved PAH therapies has been used to avoid treating patients in whom pulmonary artery pressure is elevated because of left-sided heart disease and not PAH. The inclusion and analysis in this registry of patients diagnosed with PAH with PCWP 16 to 18 mm Hg did not appear to significantly affect patient survival.
The use of ERAs, PDE-5 inhibitors, and IV, subcutaneous, or inhaled prostacyclin analogs was
Acknowledgments
Author contributions: Dr Frost is the guarantor of the manuscript and takes responsibility for the integrity of the data and the accuracy of the data analysis. Dr Frost: contributed to the study design; collection, analysis, and interpretation of data; drafting and critical review of the manuscript; approval of the final manuscript; and served as principal author.
Dr Farber: contributed to the study design; collection, analysis, and interpretation of data; drafting and critical review of the
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Funding/Support: Preparation of this manuscript was supported by Actelion Pharmaceuticals US, Inc. Funding for the REVEAL Registry is provided by Actelion Pharmaceuticals US, Inc.
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