[Evaluation effect of COMPERA 2.0 risk assessment model on prognosis of Chinese patients with pulmonary arterial hypertension]

Zhonghua Yi Xue Za Zhi. 2023 May 16;103(18):1410-1416. doi: 10.3760/cma.j.cn112137-20221212-02625.
[Article in Chinese]

Abstract

Objectives: To clarify the evaluation effect of COMPERA 2.0 risk assessment model on prognosis of pulmonary arterial hypertension (PAH) in China. Methods: Patients with newly diagnosed PAH admitted in Fuwai hospital between April 2019 and March 2022 were enrolled retrospectively and divided in low, intermediate-low, intermediate-high and high strata by scores of COMPERA 2.0 risk assessment model. All the patients were followed up by clinic or telephone. The primary endpoint was defined as a composite of all-cause mortality, exacerbated heart failure and aggravated symptoms. Kaplan-Meier analysis and log-rank trend test were used to determine the risk of endpoints among the 4 groups. Multivariate Cox proportional hazards regression were used to analyze the association between COMPERA 2.0 scores and prognosis in patients with PAH. Results: A total of 951 patients with PAH were enrolled in this study. The age [M (Q1, Q3)] of the patients was 35 (28, 47) years, of which 706 cases (74.2%) were females. A total of 328 cases (34.5%) were assigned in low strata, 264 cases (27.8%) in intermediate-low strata, 193 cases (20.3%) in intermediate-high strata, and 166 cases (17.5%) in high strata. During the duration [M (Q1, Q3)] of follow-up after discharge of 1.8 (1.0, 2.8) years, the primary endpoint was occurred in 12.8% (42/328), 21.2% (56/264), 28.5% (55/193) and 42.8% (71/166) of low, intermediate-low, intermediate-high and high strata, respectively. The rates of primary endpoint were significantly increased with strata rising (P<0.001). Multivariate Cox proportional hazards regression showed that COMPERA 2.0 risk scores were associated with the primary endpoints in PAH patients (HR=1.801, 95%CI: 1.254-2.588, P=0.001) after adjusting confounders. Conclusion: COMPERA 2.0 risk assessment model is a simple and effective tool for evaluating the prognosis of newly diagnosed PAH patients in China.

目的: 研究COMPERA 2.0评分模型在中国动脉性肺动脉高压(PAH)患者预后评估中的应用价值。 方法: 回顾性纳入2019 年4 月至2022年3月于中国医学科学院阜外医院住院的初诊PAH患者,根据COMPERA 2.0评分模型将患者分为低危组、中低危组、中高危组和高危组。通过门诊或电话进行随访,主要研究终点定义为全因死亡、心力衰竭和临床症状加重组合成的复合终点。采用Kaplan-Meier法进行生存分析,并用log-rank趋势检验分析不同组别的预后差异,运用多因素Cox比例回归模型分析COMPERA 2.0评分与PAH患者预后的关联。 结果: 共纳入951例PAH患者,年龄[MQ1Q3)]为35(28,47)岁,女性706例(74.2%)。低危组328例(34.5%),中低危组264例(27.8%),中高危组193例(20.3%),高危组166例(17.5%)。随访时间[MQ1Q3)]为1.8(1.0,2.8)年。低危组、中低危组、中高危组和高危组PAH患者复合终点发生率分别为12.8%(42/328)、21.2%(56/264)、28.5%(55/193)、42.8%(71/166),随危险分层上升呈升高趋势(P<0.001)。多因素Cox回归比例风险模型分析结果显示,高COMPERA 2.0评分与PAH患者主要终点的风险增加关联有统计学意义(HR=1.801,95%CI:1.254~2.588,P=0.001)。 结论: COMPERA 2.0评分模型是一个评估中国PAH初诊患者预后的简易且有效的工具。.

Publication types

  • English Abstract

MeSH terms

  • Adult
  • East Asian People
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Pulmonary Arterial Hypertension*
  • Retrospective Studies
  • Risk Assessment