SAT0225 Screening for Pulmonary Arterial Hypertension in Systemic Sclerosis Patients: Single Center Real-Life Performance of The Detect Algorithm

Autor: L. Scelsi, Roberto Caporali, Carlomaurizio Montecucco, V. Grosso, F. De Nard, C. Raineri, A. Gallarati, Veronica Codullo, S. Ghio
Rok vydání: 2016
Předmět:
Zdroj: Annals of the Rheumatic Diseases. 75:749.4-750
ISSN: 1468-2060
0003-4967
DOI: 10.1136/annrheumdis-2016-eular.5236
Popis: Background A new algorithm for early detection of PAH in Systemic Sclerosis (SSc) patients has been recently developed (1). However, the cost-effectiveness of this strategy has not yet been defined in a real-life setting. Objectives The aim of this study was to compare two methods of PAH screening among SSc patients for the referral to invasive tests (right heart catheterization (RHC)) in a single PH referral center. Methods Patients with SSc according to the ACR/EULAR 2013 classification criteria were enrolled in the study and prospectively followed in a Scleroderma Unit of a University Hospital which is also a PH referral center between Jan 2015 and Jan 2016 with at least 6-monthly visits. According to the ESC/ERS 2015 guidelines (2), annual screening with echocardiography, DLCO, ECG and serum biomarkers (including urate and NT-proBNP) was performed. Patients satisfying the two-steps DETECT score and/or with echocardiographically estimated Pulmonary Arterial Systolic Pressure (PASP) ≥45 mmHg or between 35–45 mmHg with unexplained dyspnea (3) were referred to an expert cardiologist to undergo RHC. Results Three-hundred patients with a diagnosis of SSc were screened and 39 patients (13%) met the criteria for the application of the DETECT algorithm (disease duration >3 years, DLCO Conclusions Our results indicate that the feasibility in clinical practice of both PAH screening methods strongly depends on the performance of a correct echocardiographic screening, with a complete assessment and quantification of right heart parameters, which often lacks in outpatient practice. In addition, applying the DETECT algorithm, a larger number of patients should be sent to RHC than those identified by solely echocardiographic parameters. Further observational studies are needed to define the real-life sensivity and cost-effectiveness of this new algorithm. References Coghlan JG et al, Ann Rheum Dis 2014. Galie N et al, Eur Respir J 2015. Hachulla E et al, Arthritis Rheum 2005. Disclosure of Interest None declared
Databáze: OpenAIRE
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