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- Title
Clinical efficacy, safety, tolerability, and survival outcome of long-term inhaled iloprost treatment in the management of pulmonary arterial hypertension: Data from prospective multicenter observational OPTION study.
- Authors
Küçükoğlu, Mehmet Serdar; Hanta, İsmail; Akdeniz, Bahri; Güllülü, Sümeyye; Atahan, Ersan; Sayın, Tamer; Okumuş, Gülfer; Önen, Zeynep Pınar; Yokuşoğlu, Mehmet; Baygül, Arzu
- Abstract
Objective: To evaluate clinical efficacy, safety and tolerability of long-term inhaled iloprost treatment in the daily practice for the management of pulmonary arterial hypertension (PAH). Methods: A total of 115 patients with PAH on inhaled iloprost treatment were included. New York Heart Association (NYHA) functional class, brain natriuretic peptide (BNP) and N-terminal pro--B-type natriuretic peptide (NT-proBNP) levels, and 6-minute walk distance (6MWD) were recorded at baseline and at 3rd to 24th month visits. Safety and tolerability of iloprost treatment were also evaluated during follow-up, as were the survival, clinical worsening, and the related risk factors. Results: The treatment was associated with an increase in the percentage NYHA functional class II (from 0.0% at enrolment to 36.2% at 24th month visit) patients but no significant difference was noted in 6MWD values. Clinical worsening was observed in 63.5% patients, while survival rate was 69.6%. NT-proBNP levels were significantly higher in non-survivors than in survivors (p=0.042). Cox regression analysis revealed the association of female sex [odds ratio (OR)=0.318; 95% confidence interval (CI), 0.128-0.792; p=0.014] and scleroderma-related PAH (OR=0.347; 95% CI, 0.140-0.860; p=0.022) with significantly lower risk (3.14 fold and 2.88 fold, respectively) of mortality. Conclusion: Our findings indicate favorable efficacy, safety, and tolerability of long-term iloprost treatment in the management of PAH, whereas improved NYHA functional class was not accompanied with a significant change in 6MWD values. Patient age was a risk factor for clinical worsening, while female sex, scleroderma subtype, and lower NT-proBNP levels were associated with significantly lower mortality risk.
- Subjects
PULMONARY arterial hypertension; SURVIVAL rate; PULMONARY hypertension; BRAIN natriuretic factor; REGRESSION analysis; SCIENTIFIC observation
- Publication
Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi, 2021, Vol 25, Issue 10, p721
- ISSN
2149-2263
- Publication type
Article
- DOI
10.5152/AnatolJCardiol.2021.03009