Initial tadalafil and ambrisentan combination therapy in pulmonary arterial hypertension: cLinical and haemodYnamic long-term efficacy (ITALY study)

被引:15
作者
D'Alto, Michele [1 ]
Romeo, Emanuele [1 ]
Argiento, Paola [1 ]
Paciocco, Giuseppe [2 ]
Prediletto, Renato [3 ]
Ghio, Stefano [4 ]
Correale, Michele [5 ]
Lo Giudice, Francesco [6 ]
Badagliacca, Roberto [7 ]
Greco, Alessandra [4 ]
Vizza, Carmine Dario [7 ]
机构
[1] Univ Naples 2, Monaldi Hosp, Dept Cardiol, Naples, Italy
[2] Univ Milano Bicocca, Monza, MB, Italy
[3] CNR, Fdn Monasterio CNR Reg Toscana, Ist Fisiol Clin, Pisa, Italy
[4] Fdn IRCCS Policlin San Matteo, Pavia, Italy
[5] Univ Hosp, Dept Cardiol, Osped Riuniti, Foggia, Italy
[6] Univ Hosp Cattinara, Dept Cardiol, ASUITS, Trieste, Italy
[7] Univ Roma La Sapienza, Dept Cardiovasc & Resp Dis, Rome, Italy
关键词
outcome; pulmonary arterial hypertension; SURVIVAL; ASSOCIATION; MACITENTAN; AMBITION; REGISTRY;
D O I
10.2459/JCM.0000000000000590
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
AimsInitial combination therapy with ambrisentan and tadalafil (upfront therapy) offers clinical benefits in pulmonary arterial hypertension (PAH) and reduces the risk of clinical failure compared with monotherapy in naive patients. The aim of study is to assess the efficacy of a 12-month upfront therapy with ambrisentan and tadalafil in improving haemodynamics in incident PAH patients.MethodsThis is a multicentre retrospective analysis of real-world Italian clinical data in 56 patients with newly diagnosed PAH. Clinical evaluations, including demographics, medical history, WHO functional class, 6-min walk distance, and right heart catheterization, were collected from the patients' medical records at baseline and at 12-month follow-up.ResultsAt baseline, there were 16, 34, and 6 patients in WHO functional class II, III, and IV, respectively. Over a median follow-up of 12 months, 54 (96%) patients were still alive, 6 (11%) of whom received parenteral prostanoids. Ambrisentan-tadalafil combination was associated with significant improvements in WHO functional class (2.20.8 vs. 2.8 +/- 0.6, P<0.001, improved in 29 patients), exercise capacity (395 +/- 123 vs. 353 +/- 101m, P=0.039), N-terminal probrain natriuretic peptide (528 +/- 493 vs. 829 +/- 620pg/ml; P=0.009), and haemodynamics (right atrial pressure 7 +/- 4 vs. 9 +/- 5mmHg, P=0.02; mean pulmonary artery pressure 45 +/- 15 vs. 50 +/- 13mmHg, P=0.03; cardiac index 3.0 +/- 1.0 vs. 2.5 +/- 0.9l/min/m(2), P=0.001; pulmonary vascular resistance 8 +/- 4 vs. 11 +/- 6 Wood units, P=0.001) compared with baseline.ConclusionsInitial combination therapy with ambrisentan and tadalafil offers clinical benefits and significant haemodynamic improvement in newly diagnosed PAH patients.
引用
收藏
页码:12 / 17
页数:6
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