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Title: Nyha classification, creatinine and oral anticoagulation are independent risk factors for adverse outcome in patients with Eisenmenger’s syndrome
Authors: Van De Bruaene, Alexander ×
Delcroix, Marion
Pasquet, Agnes
De Backer, Julie
De Pauw, Michel
Naeije, Robert
Vachiéry, Jean-Luc
Paelinck, Bernard
Morissens, Marielle
Budts, Werner #
Issue Date: Nov-2010
Publisher: Lippincott Williams & Wilkins
Series Title: Circulation
Conference: AHA Scientific Sessions 2010 edition:2010 location:Chicago, US date:14-20 November 2010
Abstract: Background
Pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD) usually results from a systemic-to-pulmonary shunt. Eisenmenger’s syndrome (ES) is characterised by severe irreversible PAH and reversal of a previous systemic-to-pulmonary shunt. This study aimed at evaluating predictors of adverse outcome in patients with ES.
Methods
In 2006, all ES patients, older than 18 years, were selected through the local databases of ten centres in Belgium and prospectively followed. Demographic, clinical, biochemical and treatment data were entered into a web based registry. A composite endpoint, defined as all-cause mortality, lung transplantation, hospitalisation due to cardiopulmonary causes and the need for additional pulmonary hypertensive treatment, was used as independent variable. Uni- and multivariate Cox regression analysis was performed.
Results
A total of 58 patients were included in the registry. Twenty-five patients reached the prespecified endpoint over a median follow-up time of 3 years. According to univariate Cox regression analysis, NYHA classification (P=0.031), creatinine (P=0.006) and the use of oral anticoagulation (P=0.009) correlated with adverse outcome. Multivariate analysis showed that NYHA classification (HR 2.25; 95%CI 1.08-4.68; P=0.03), creatinine (HR 4.47; 95%CI 1.44-13.90; P=0.01) and oral anticoagulation (HR 3.45; 95%CI 1.43-8.33; P=0.006) were independent predictors of adverse outcome.
Conclusions
Higher NYHA classification and higher creatinine levels were predictive for adverse outcome in patients with Eisenmenger’s syndrome. To our knowledge, this is the first study indicating that the use of oral anticoagulation is also an independent predictor of adverse outcome in patients with Eisenmenger’s syndrome.
ISSN: 0009-7322
Publication status: published
KU Leuven publication type: IMa
Appears in Collections:Cardiology
Pneumology
× corresponding author
# (joint) last author

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