Abstract | BACKGROUND: METHODS: We assessed HbA1c levels in 115 patients newly diagnosed with PAH (79 females and 36 males; mean age 49.2 years; idiopathic n = 67, collagen vascular disease n = 16, congenital heart defect n = 19, pulmonary veno-occlusive disease n = 8, portopulmonary n = 5). No patients had diabetes or were receiving anti-diabetic medication or systemic steroids. After initiation of pulmonary vasoactive treatment, patients remained in long-term follow-up. RESULTS: Initially, patients were in an advanced stage of disease (mean pulmonary arterial pressure 53 ± 18 mm Hg, cardiac index 2.3 ± 0.8 liters/min/m2) with a 6-minute-walk distance of 337 ± 123 meters, and in NYHA Functional Class 3.0 ± 0.7. The HbA1c was 5.73 ± 0.75%. A moderate but statistically significant positive correlation was observed between HbA1c levels and BNP (r(p) = 0.41, p = 0.014), but no correlation was found with hemodynamics or 6-minute-walk distance. The 5-year survival rate for the entire group was 68%. Kaplan-Meier analysis and multivariate Cox proportional hazard models correcting for demographic and clinical covariates revealed that patients with HbA1c < 5.7% had a significantly better 5-year survival compared with those having higher initial values (85.1% vs. 55.9%; log rank p = 0.002). HbA1c was a predictor of all-cause mortality with a hazard ratio of 2.23 (95% CI 1.06 to 4.70; p = 0.034) per 1-unit increase of HbA1c. CONCLUSIONS:
|
Authors | Michael J Belly, Henning Tiede, Rory E Morty, Richard Schulz, Robert Voswinckel, Christian Tanislav, Horst Olschewski, Hossein A Ghofrani, Werner Seeger, Frank Reichenberger |
Journal | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
(J Heart Lung Transplant)
Vol. 31
Issue 10
Pg. 1109-14
(Oct 2012)
ISSN: 1557-3117 [Electronic] United States |
PMID | 22975101
(Publication Type: Journal Article)
|
Copyright | Copyright © 2012 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Biomarkers
- Glycated Hemoglobin A
|
Topics |
- Adult
- Aged
- Biomarkers
(blood)
- Familial Primary Pulmonary Hypertension
- Female
- Follow-Up Studies
- Glycated Hemoglobin
(metabolism)
- Humans
- Hypertension, Pulmonary
(blood, diagnosis, mortality)
- Kaplan-Meier Estimate
- Longitudinal Studies
- Male
- Middle Aged
- Prognosis
- Proportional Hazards Models
- Survival Rate
|