COPD patients with pulmonary hypertension have worse prognosis, finds study

In a study done by Carmine Dario Vizza and colleagues, it was discovered that patients with pulmonary hypertension (PH) in Chronic Obstructive Pulmonary Disease (COPD) were functionally more impaired and had a worse prognosis than those with idiopathic pulmonary arterial hypertension (IPAH). Sex, 6-min walking distance (6MWD), and pulmonary vascular resistance were all predictors of mortality in the PH in COPD group (PVR). The study's goal was to identify the variables that influence the outcome of PH in COPD patients.

The study and its findings were published in CHEST Journal on 24th September, 2021.

Researchers compared the characteristics and outcomes of patients in the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA) with moderate or severe PH in COPD as defined during the 6th PH World Symposium who received medical therapy for PH to patients with idiopathic pulmonary arterial hypertension (IPAH).

The current study covers the characteristics and outcomes of individuals with PH in COPD who were treated with PAH-approved medicines. Despite equal hemodynamic impairment, individuals with PH in COPD had a poorer clinical state and a worse transplant-free survival than patients with IPAH. The probability of transplantation or mortality in individuals with PH in COPD was associated to male sex, low 6MWD, and high PVR rather than the degree of airflow obstruction. Patients with severe PH in COPD had poorer outcomes than patients with moderate PH in COPD, demonstrating that the difference between moderate and severe PH in COPD, presented at the most recent PH global symposium, has clinical value. Furthermore, the findings suggest that certain patients with severe PH in COPD may benefit from therapy with PAH medicines. The death rate in patients with severe PH in COPD was about 12% per year, which was roughly double the reported mortality rate in the IPAH group.

In Conclusion, according to the findings, PH-targeted pharmacological therapy in patients with COPD and severe PH may improve exercise tolerance and WHO FC in a subset of patients, and patients with COPD and PH who respond to medication may have a better prognosis than those who do not demonstrate clinical improvement.

Reference:

Vizza, C. D., Hoeper, M. M., Huscher, D., Pittrow, D., Benjamin, N., Olsson, K. M., Ghofrani, H. A., Held, M., Klose, H., Lange, T., Rosenkranz, S., Dumitrescu, D., Badagliacca, R., Claussen, M., Halank, M., Vonk-Noordegraaf, A., Skowasch, D., Ewert, R., Gibbs, J. S. R., … Grünig, E. (2021). Pulmonary Hypertension in Patients With COPD. Chest, 160(2), 678–689. https://doi.org/10.1016/j.chest.2021.02.012