SESSION TITLE: Pulmonary Vascular Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Prostacyclin therapy has become a standard of current management for patients with severe pulmonary arterial hypertension (PAH). CurrentlY therapy may be administered via inhaled, oral, and parenteral routes, however there use is often reserved for patients with severe disease. This study aimed to assess the prevalence and effect via hemodynamic evaluation and functional outcome measurements of inhaled, oral, and parenteral prostacyclin therapy among pulmonary hypertension clinic patients. METHODS: This was a retrospective cohort study of pulmonary hypertension (PH) clinic patients at Keck Medical Center. Patients were studied from time of initial clinic visit and most recent follow up. Data ranged from 2011 to 2020. Patient demographics, hemodynamics via right heart catheterization (RHC), transthoracic echocardiography findings (TTE), and functional capacity via six-minute walk testing (6MWT) were collected. Patients were then separated by presence of prostacyclin therapy and route of administration if present. RESULTS: Data was collected on 473 PH patients, 298 of which had complete therapy data and were included in the final analysis. WHO group 1 PAH patients comprised 72% (n = 214) of all patients. The composition of prostacyclin therapy was as follows 152 (51%) no prostacyclin therapy (NP), 29 (9.7%) inhaled prostacyclin therapy (IP), 25 (8.3%) oral prostacyclin therapy (OP), 85 (28.5%) parenteral prostacyclin therapy (PP), and 7 (2.3%) combination therapy. Percentage of patients in each group with PAH was as follows NP (58.6%), IP (75.9%), OP (80%), PP (90.6%), and combination (85.7%). RHC hemodynamics revealed a significant relationship between increasing pulmonary artery pressures and pulmonary vascular resistance (PVR) and therapy in order from NP to IP to OP to PP at initial and follow up visit. TTE findings showed a significant relationship between increasing right ventricular (RV) dilation, RV dysfunction, RVSP, presence of pericardial effusion, and prostacyclin therapy from NP to IP to OP to PP. 6MWT revealed the PP group had the furthest distance walked and had an increase between at follow up while the IP group had the shortest 6MWT distance and greatest reduction in average 6MWT distance at follow up. CONCLUSIONS: The cohort of patients between types of therapy differed significantly in baseline characteristics and outcomes on cardiopulmonary hemodynamics and functional status. The PP group compared to IP and OP were shown to have more severe pulmonary hypertension. Despite that, they had greater 6MWT distances and even improved values from initial to follow up testing. The increase in distance adds to the body of literature suggesting the benefit of parenteral prostacyclin long term in comparison to other modes of drug delivery. CLINICAL IMPLICATIONS: This study may contribute to identifying subsets of patients with pulmonary hypertension who would benefit from prostacyclin therapy. DISCLOSURES: No relevant relationships by Tiffany Chang, source=Web Response No relevant relationships by Lucas Cruz, source=Web Response No relevant relationships by Jared Geibig, source=Web Response No relevant relationships by Moses Koo, source=Web Response No relevant relationships by Ashil Panchal, source=Web Response Speaker/Speaker's Bureau relationship with Actelion, United therapeutic, and Bayer Please note: $20001 - $100000 Added 05/30/2020 by Bassam Yaghmour, source=Web Response, value=Honoraria
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