Abstract | BACKGROUND: METHODS AND RESULTS: Data on all Eisenmenger patients attending our center over the past decade were collected. Survival rates were compared between patients on and off AT with the use of a modified version of the Cox model, which treats AT as a time-varying covariate. Baseline differences were adjusted for the use of propensity scores. A total of 229 patients (aged 34.5 + or - 12.6 years; 35.4% male) were included. The majority had complex anatomy, and 53.7% were in New York Heart Association class > or = III at baseline assessment. Mean resting saturations were 84.3%. Sixty-eight patients (29.7%) either were on AT or had AT initiated during follow-up. During a median follow-up of 4.0 years, 52 patients died, only 2 of them while on AT. Patients on AT were at a significantly lower risk of death, both unadjusted and after adjustment for baseline clinical differences by propensity score regression adjustment (C statistic=0.80; hazard ratio, 0.16; 95% confidence interval, 0.04 to 0.71; P=0.015) and propensity score matching (hazard ratio, 0.10; 95% confidence interval, 0.01 to 0.78; P=0.028). CONCLUSIONS: AT for pulmonary arterial hypertension in a contemporary cohort of adults with Eisenmenger syndrome was associated with a lower risk of death. Survival benefits should be considered together with improved hemodynamics and functional class when decisions are made about AT in this population.
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Authors | Konstantinos Dimopoulos, Ryo Inuzuka, Sara Goletto, Georgios Giannakoulas, Lorna Swan, Stephen J Wort, Michael A Gatzoulis |
Journal | Circulation
(Circulation)
Vol. 121
Issue 1
Pg. 20-5
(Jan 05 2010)
ISSN: 1524-4539 [Electronic] United States |
PMID | 20026774
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Adult
- Eisenmenger Complex
(mortality)
- Female
- Follow-Up Studies
- Humans
- Hypertension, Pulmonary
(drug therapy, mortality)
- Male
- Middle Aged
- Proportional Hazards Models
- Pulmonary Circulation
(drug effects)
- Retrospective Studies
- Risk Factors
- Vasodilator Agents
(therapeutic use)
- Young Adult
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