A Correlation Between Monocyte to Lymphocyte Ratio and Long-Term Prognosis in Patients With Coronary Artery Disease After PCI

Monocyte to lymphocyte ratio (MLR) has been confirmed as a novel marker of poor prognosis in patients with coronary heart disease (CAD). However, the prognosis value of MLR for patients with CAD after percutaneous coronary intervention (PCI) needs further studies. In present study, we aimed to investigate the correlation between MLR and long-term prognosis in patients with CAD after PCI. A total of 3,461 patients with CAD after PCI at the First Affiliated Hospital of Zhengzhou University were included in the analysis. According to the cutoff value of MLR, all of the patients were divided into 2 groups: the low-MLR group (<0.34, n = 2338) and the high-MLR group (≥0.34, n = 1123). Kaplan–Meier curve was performed to compare the long-term outcome. Multivariate COX regression analysis was used to assess the independent predictors for all-cause mortality, cardiac mortality and MACCEs. Multivariate COX regression analysis showed that the high MLR group had significantly increased all-cause mortality (ACM) [hazard ratio (HR) = 1.366, 95% confidence interval (CI): 1.366-3.650, p = 0.001] and cardiac mortality (CM) (HR = 2.379, 95%CI: 1.611-3,511, p < 0.001) compared to the low MLR group. And high MLR was also found to be highly associated with major adverse cardiovascular and cerebrovascular events (MACCEs) (HR = 1.227, 95%CI: 1.003-1.500, p = 0.047) in patients with CAD undergoing PCI. MLR was an independent predictor of ACM, CM and MACCEs in CAD patients who underwent PCI.

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Multimodality treatment of non small cells lung cancer (NSCLC) brain metastases: Long term outcome

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.17046 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 17046-17046

Author(s):

A. Cassano ◽

A. Pompucci ◽

E. D’Argento ◽

G. Schinzari ◽

A. Di Chirico ◽

...

Keyword(s):

Lung Cancer ◽

Regression Analysis ◽

Brain Metastases ◽

Cox Regression ◽

Radical Surgery ◽

Therapeutic Option ◽

Term Outcome ◽

Long Term Outcome ◽

Cox Regression Analysis

17046 Background: Lung cancer is the most common cause of cancer deaths and has the highest incidence for brain metastases of all malignancies. The prognosis of these patients (pts) remain poor with a median survival of 4–5 months. Whole brain radiation therapy (WBRT) in inoperable brain metastases prolongs survival to 3–5 months. In pts with 1 or ≤ 3 brain metastases neurosurgical resection improves median survival to 3.5–8 months. The aim of this study was to evaluate the long-term outcome of patients with brain metastases from NSCLC treated with multimodal strategy, including systemic chemotherapy, neurosurgery and radiotherapy. Methods: From 1997 to 2005, 56 pts were considered. Inclusion criteria were: single or multiple NSCLC brain metastases suitable of surgery; Karnofsky performance status ≥ 70%; controlled extracranial disease with Cisplatin-based chemotherapy; life expectancy > 4 months. Surgery was followed by 40 Gy WBRT. Statistical analysis was performed using the Kaplan-Meier method and Cox-regression analysis. Results: The median age was 58.4 years. The histological types were adenocarcinoma in 35 pts (62.5%), squamous cell carcinoma in 11 pts (19.7%) and large cell carcinoma in 10 pts (17.8%). The lesions were single in 39/56 pts (69.6%) and multiple in the other pts (30.4%). Radical surgery was performed in 37 pts (66%), while surgical citoreduction was possible in 19 pts (34%). The median follow-up period was 22.12 months (range 2–90 months). Overall survival (OS) of the whole group was 12.8 months; OS of pts radically resected was 16.5 months while OS of pts partially resected was 7.2 months. Based on Cox-regression analysis, age < 65 years and radical resection were independent predictors of survival (respectively p = 0.004–95% CI 1.46–7.6 and p = 0.04–95% CI 1.03–4.97), while the number of lesions was not relevant in terms of OS. Conclusions: Analysis of long-term outcome seems to confirm that the combined treatment of NSCLC brain metastases is a primary therapeutic option. In our series of 56 patients, radical surgery, not the number of metastases, was related with prolonged survival. Further randomized studies comparing surgery+WBRT vs gamma-knife-radiosurgery could define the best therapeutic option in the different subsets of pts. No significant financial relationships to disclose.

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Clinicopathological Features of Remnant Gastric Cancer After Gastrectomy

The American Surgeon ◽

10.1177/00031348211056281 ◽

2021 ◽

pp. 000313482110562

Author(s):

Kenichi Iwasaki ◽

Edward Barroga ◽

Yota Shimoda ◽

Masaya Enomoto ◽

Erika Yamada ◽

...

Keyword(s):

Medical Records ◽

Tumor Invasion ◽

Cox Regression ◽

Remnant Stomach ◽

Invasion Depth ◽

Term Outcome ◽

Long Term Outcome ◽

Cox Regression Analysis ◽

Tumor Invasion Depth

Background Remnant gastric cancer (RGC) encompasses all cancers arising from the remnant stomach. Various studies have reported on RGC and its prognosis, but no consensus on its surgical treatment and postoperative management has been reached. Moreover, the correlation between the clinicopathological characteristics and long-term outcomes of RGC remains unclear. This study investigated the clinicopathological factors associated with the long-term survival of RGC patients. Methods The medical records (March 1993-September 2020) of 104 RGC patients from Tokyo Medical University Hospital database were analyzed. Of these 104 patients, the medical records of 63 patients who underwent surgical curative resection were analyzed using R. Kaplan-Meier plots of cumulative incidence of RGC were made. Differences in survival rates were compared using the log-rank test. Prognostic factors were analyzed using multivariate Cox regression analysis ( P < .05). Results Of the 104 RGC patients, 63 underwent total remnant stomach excision. The median time from the first surgery to the total excision was 10 years. The 5-year survival rate of the 63 RGC patients was .55 ((95% CI); .417-.671). The clinicopathological factors that were significantly associated with the long-term outcome of the RGC patients were tumor diameter (≥3.5 cm), presence or absence of combined resection of multiple organs, tumor invasion (deeper than T2), TNM stage, and postoperative morbidity. The multivariate Cox regression analysis showed that tumor invasion depth was the only independent prognostic factor for RGC patients [HR (95% CI): 5.49 (2.629-11.5), P ≤ .005]. Conclusions Among prognostic factors, tumor invasion depth was the only independent factor affecting RGC’s long-term outcome.

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P1885Cha2ds-2vasc score lacks of ability to predict mortality in patients attending the emergency department with atrial fibrillation in the presence of troponin i

European Heart Journal ◽

10.1093/eurheartj/ehz748.0633 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

M I Gonzalez Del Hoyo ◽

G Cediel ◽

A Carrasquer ◽

G Bonet ◽

K Vasquez-Nunez ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Emergency Department ◽

Regression Analysis ◽

Troponin I ◽

Cox Regression ◽

Cox Regression Analysis ◽

All Cause Mortality

Abstract Background CHA2DS2-VASc score has been used as a surrogate marker for predicting outcomes beyond thromboembolic risk in patients with atrial fibrillation (AF). Likewise, cardiac troponin I (cTnI) is a predictor of mortality in AF. Purpose This study aimed to investigate the association of cTnI and CHA2DS2-VASc score with long-term prognosis in patients admitted to the emergency department with AF. Methods A retrospective cohort study conducted between January 2012 and December 2013, enrolling patients admitted to the emergency department with AF and having documented cTnI measurements. CHA2DS2-VASc score was estimated. Primary endpoint was 5-year all-cause mortality, readmission for heart failure (HF), readmission for myocardial infarction (MI) and the composite end point of major adverse cardiac events defined as death, readmission for HF or readmission for MI (MACE). Results A total of 578 patients with AF were studied, of whom 252 patients had elevated levels of cTnI (43.6%) and 334 patients had CHA2DS2-VASc score >3 (57.8%). Patients with elevated cTnI tended to be oldercompared with those who did not have cTnI elevation and were more frequently comorbid and of higher ischemic risk, including hypertension, prior MI, prior HF, chronic renal failure and peripheral artery disease. The overall median CHA2DS2-VASc score was higher in those with cTnI elevation compared to those patients elevated cTnI levels (4.2 vs 3.3 points, p<0.001). Main diagnoses at hospital discharge were tachyarrhythmia 30.3%, followed by heart failure 17.7%, respiratory infections 9.5% and acute coronary syndrome 7.3%. At 5-year follow-up, all-cause death was significantly higher for patients with cTnI elevation compared with those who did not have cTnI elevation (56.4% vs. 27%; logrank test p<0.001). Specifically, for readmissions for HF and readmissions for MI there were no differences in between patients with or without cTnI elevation. In addition, MACE was reached in 165 patients (65.5%) with cTnI elevation, compare to 126 patients (38.7%) without cTnI elevation (p<0.001). On multivariable Cox regression analysis, cTnI elevation was an independent predictor of all-cause death (hazard ratio, 1.67, 95% confidence interval [CI]: 1.24–2.26, p=0.001) and of MACE (hazard ratio 1.47, 95% confidence interval 1.15–1.88; P=0.002), but it did not reach statistical significance for readmissions for MI and readmissions for HF. CHA2DS2-VASc score was a predictor on univariate Cox regression analysis for each endpoint, but it did not reach significance on multivariable Cox regression analysis for any endpoint. Conclusions cTnI is independently associated with long-term all-cause mortality in patients attending the emergency department with AF. cTnI compared to CHA2DS2-VASc score is thus a biomarker with predictive capacity for mortality in late follow-up, conferring utility in the risk stratification of patients with atrial fibrillation.

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Prognostic factors in the persistence of posttraumatic epilepsy after penetrating head injuries sustained in war

Journal of Neurosurgery ◽

10.3171/2008.4.17519 ◽

2009 ◽

Vol 110 (2) ◽

pp. 319-326 ◽

Cited By ~ 24

Author(s):

Behzad Eftekhar ◽

Mohammad Ali Sahraian ◽

Banafsheh Nouralishahi ◽

Ali Khaji ◽

Zahra Vahabi ◽

...

Keyword(s):

Prognostic Factors ◽

Cox Regression ◽

Head Injuries ◽

Clinical Findings ◽

Term Outcome ◽

Long Term Outcome ◽

Cox Regression Analysis ◽

Posttraumatic Epilepsy ◽

Kaplan Meier

Object The goal of this paper was to investigate the long-term outcome and the possible prognostic factors that might have influenced the persistence of posttraumatic epilepsy after penetrating head injuries sustained during the Iraq–Iran war (1980–1988). Methods In this retrospective study, the authors evaluated 189 patients who sustained penetrating head injury and suffered posttraumatic epilepsy during the Iraq–Iran war (mean 18.6 ± 4.7 years after injury). The probabilities of persistent seizures (seizure occurrence in the past 2 years) in different periods after injury were estimated using the Kaplan-Meier method. The possible prognostic factors (patients and injury characteristics, clinical findings, and seizure characteristics) were studied using log-rank and Cox regression analysis. Results The probability of persistent seizures was 86.4% after 16 years and 74.7% after 21 years. In patients with < 3 pieces of shrapnel or no sphincter disturbances during seizure attacks, the probability of being seizure free after these 16 and 21 years was significantly higher. Conclusions Early seizures, prophylactic antiepileptics drugs, and surgical intervention did not significantly affect long-term outcome in regard to persistence of seizures.

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Long term clinical impact of successful recanalization of chronic total occlusion in patients with and without type 2 diabetes mellitus

10.21203/rs.3.rs-28914/v1 ◽

2020 ◽

Author(s):

Chuan-Tsai Tsai ◽

Wei-Chieh Huang ◽

Hsin-I Teng ◽

Yi-Lin Tsai ◽

Tse-Min Lu

Keyword(s):

Diabetes Mellitus ◽

Cox Regression ◽

Total Occlusion ◽

Long Term Outcome ◽

Chronic Total Occlusions ◽

Cox Regression Analysis ◽

All Cause Mortality ◽

Diabetes Patients

Abstract Background Diabetes mellitus is one of the risk factors for coronary artery disease and frequently associated with multivessels disease and poor clinical outcomes. Long term outcome of successful revascularization of chronic total occlusions (CTO) in diabetes patients remains controversial. Methods and results From January 2005 to December 2015, 739 patients who underwent revascularization for CTO in Taipei Veterans General Hospital were included in this study, of which 313 (42%) patients were diabetes patients. Overall successful rate of revascularization was 619 (84%) patients whereas that in diabetics and non-diabetics were 265 (84%) and 354 (83%) respectively. Median follow up was 1095 days (median: 5 years, interquartile range: 1–10 years). During 3 years follow-up period, 59 (10%) in successful group and 18 (15%) patients in failure group died. Although successful revascularization of CTO was non-significantly associated with better outcome in total cohort (Hazard ratio (HR):0.593, 95% confidence interval (CI): 0.349–0.008, P:0.054), it might be associated with lower risk of all-cause mortality (HR: 0.307, 95% CI: 0.156–0.604, P: 0.001) and CV mortality (HR: 0.266, 95% CI: 0.095–0.748, P: 0.012) in diabetics (P: 0.512). In contrast, successful CTO revascularization didn’t improve outcomes in non-diabetics (all p > 0.05). In multivariate cox regression analysis, successful CTO revascularization remained an independent predictor for 3-years survival in diabetic subgroup (HR: 0.289, 95% CI: 0.125–0.667, P: 0.004). The multivariate analysis result was similar after propensity score matching (all-cause mortality, HR: 0.348, 95% CI: 0.142–0.851, P: 0.021). Conclusion Successful CTO revascularization was associated with reduced long term all-cause/cardiovascular mortality in diabetics but not in non-diabetic population.

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Long-term effects of citric acid-based bicarbonate haemodialysis on patient outcomes: a survival propensity score–matched study in western France

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfz274 ◽

2020 ◽

Vol 35 (7) ◽

pp. 1228-1236 ◽

Cited By ~ 1

Author(s):

Jacky Potier ◽

Thibault Dolley-Hitze ◽

Didier Hamel ◽

Isabelle Landru ◽

Erick Cardineau ◽

...

Keyword(s):

Regression Analysis ◽

Patient Outcomes ◽

Cox Regression ◽

Univariate Analysis ◽

Long Term Effects ◽

Cox Regression Analysis ◽

Kaplan Meier ◽

Statistical Relevance ◽

All Cause Mortality

Abstract Background Citric acid–based bicarbonate haemodialysis (CIT-HD) has gained more clinical acceptance over the last few years in France and is a substitute for other acidifiers [e.g. acetic acid (CH3COOH) and hydrochloric acid (HCl)]. This trend was justified by several clinical benefits compared with CH3COOH as well as the desire to avoid the consequences of the corrosive action of HCl, but a nationwide clinical report raised concerns about the long-term safety of CIT-HD. The aim of this study was to assess the long-term effects of CIT-HD exposure on patient outcomes in western France. Methods This is a population-based retrospective multicentre observational study performed in 1132 incident end-stage kidney disease patients in five sanitary territories in western France who started their renal replacement therapy after 1 January 2008 and followed up through 15 October 2018. Relevant data, collected prospectively with the same medical software, were anonymously aggregated for the purposes of the study. The primary goal of this study was to investigate the effects of citrate exposure on all-cause mortality. To provide a control group to CIT-HD one, propensity score matching (PSM) at 2:1 was performed in two steps: the first analysis was intended to be exploratory, comparing patients who received citrate ≤80% of the time (CIT-HD ≤80) versus those who received citrate >80% of the time (CIT-HD >80), while the second analysis was intended to be explanatory in comparing patients with 0% (CIT-HD0) versus 100% citrate time exposure (CIT-HD100). Results After PSM, in the exploratory part of the analysis, 432 CIT-HD ≤80 patients were compared with 216 CIT-HD >80 patients and no difference was found for all-cause mortality using the Kaplan–Meier model (log-rank 0.97), univariate Cox regression analysis {hazard ratio [HR] 1.01 [95% confidence interval (CI) 0.71–1.40]} and multivariate Cox regression analysis [HR 1.11 (95% CI 0.76–1.61)] when adjusted for nine variables with clinical pertinence and high statistical relevance in the univariate analysis. In the explanatory part of the analysis, 316 CIT-HD0 patients were then compared with 158 CIT-HD100 patients and no difference was found using the Kaplan–Meier model (log-rank 0.06), univariate Cox regression analysis [HR 0.69 (95% CI 0.47–1.03)] and multivariate Cox regression analysis [HR 0.87 (95% CI 0.57–1.33)] when adjusted for seven variables with clinical pertinence and high statistical relevance in the univariate analysis. Conclusions Findings of this study support the notion that CIT-HD exposure ≤6 years has no significant effect on all-cause mortality in HD patients. This finding remains true for patients receiving high-volume online haemodiafiltration, a modality most frequently prescribed in this cohort.

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Incidence and long term prognosis of papillary renal cell carcinoma

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e16020 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e16020-e16020

Author(s):

A. J. Schrader ◽

S. Rauer-Bruening ◽

P. J. Olbert ◽

A. Hegele ◽

J. Rustemeier ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Regression Analysis ◽

Renal Cell ◽

Cox Regression ◽

Clear Cell ◽

Papillary Renal Cell Carcinoma ◽

Renal Surgery ◽

Cox Regression Analysis ◽

Long Term Prognosis

e16020 Background: Papillary renal cell carcinoma (pRCC) represents the largest subgroup of non clear-cell kidney cancer. In this study we assessed tumour characteristics and long-term prognosis of patients with pRCC in comparison with conventional clear-cell cancer (ccRCC). Methods: We evaluated 744 patients who had undergone renal surgery for RCC between 1990 and 2005. The mean follow-up was 5.6 years. Results: Both groups pRCC and ccRCC were alike concerning age, body mass index, and the incidence of regional lymph node or distant metastasis at diagnosis. The percentage of male patients was higher in pRCC than in ccRCC (73.8 vs. 60.3%, p = 0.006). Even though patients with pRCC presented more often with smaller (p = 0.039) and low grade tumours (p = 0.006), there was no statistically significant difference in tumour recurrence or tumour related death. Moreover, looking at the whole cohort Kaplan-Meier curves revealed no differences regarding tumour specific survival between pRCC and ccRCC (p = 0.94; 5-year survival 78% vs. 77%). However, we observed a trend towards an improved outcome for organ confined (pT1–2) cancer, but a significantly inferior prognosis for locally advanced stage (pT3–4) and/or metastatic papillary tumours at the time of renal surgery. However, applying multivariate analysis including age, sex, and tumour grade, histology could neither be retained as a significant independent prognostic marker in the metastatic setting (p = 0.068, cox regression analysis) nor in a subgroup analysis focussing on patients with advanced cancer (pT3–4 and/or N+/M+; p = 0.064, cox regression analysis). Conclusions: Even though pRCC and ccRCC differ significantly in many aspects including histology and genetic alterations, in all, their long term prognosis is comparable. As we could not confirm a favourable clinical course for pRCC in general, standardized aftercare programmes and - if necessary - systemic treatment, especially in the era of novel targeted drugs, are also needed for this common RCC subtype. In addition, routine histologic subtyping of pRCC is strongly recommended. No significant financial relationships to disclose.

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Comparative Survival Analysis of Urea Kinetic Based Indices

The International Journal of Artificial Organs ◽

10.1177/039139880502800605 ◽

2005 ◽

Vol 28 (6) ◽

pp. 566-575 ◽

Cited By ~ 7

Author(s):

M. Stosovic ◽

M. Stanojevic ◽

M. Radovic ◽

R. Naumovic ◽

D. Jovanovic ◽

...

Keyword(s):

Regression Analysis ◽

Survival Analysis ◽

Cox Regression ◽

Single Center ◽

Dialysis Dose ◽

Cox Regression Analysis ◽

Single Center Study ◽

All Cause Mortality ◽

Center Study

Background Although urea kinetic modeling indices for measuring dialysis dose are recommended by world expert groups, it is not quite clear whether some of these are superior in predicting the outcome over others. This prospective, single-center study was carried out with the aim to compare predictive value of different indices and methods of measuring dialysis dose. Methods The analysis included 93 anuric patients having been on hemodialysis for at least 2 years who were followed-up for 75-months. The dialysis dose was measured by Kt/V (formal UKM, 3 and 2 urea samples), Kt/V (Daugirdas), Kt/V (Lowrie), eKt/V (Daugirdas), URR and TAC urea. Results Correlations between dialysis indices and survival time were significant for all indices (p<0.01) except for TAC. All indices, except for TAC urea, were significant predictors of mortality (multivariate Cox regression analysis; p<0.01) and differences of significant levels among these colinear parameters were small. Conclusion All examined indices except for TAC urea were highly predictive of patient mortality. Daugirdas and Lowrie simplified Kt/V indices are as predictive of all-cause mortality as more complex formal UKM methods in long-term patients on a 3×4h/week schedule.

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Neutrophil to Lymphocyte Ratio as a Predictor of Long-Term Outcome in Peritoneal Dialysis Patients: A 5-Year Cohort Study

Blood Purification ◽

10.1159/000510552 ◽

2021 ◽

pp. 1-7

Author(s):

Lin Zhang ◽

Yuxin Nie ◽

Man Guo ◽

Li Wang ◽

Yiqin Shi ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Cardiovascular Mortality ◽

Cox Proportional Hazards Model ◽

Older Age ◽

Neutrophil To Lymphocyte Ratio ◽

Term Outcome ◽

Long Term Outcome ◽

Lymphocyte Ratio ◽

All Cause Mortality

Introduction: The mortality of peritoneal dialysis (PD) patients remains high. The neutrophil to lymphocyte ratio (NLR), as an indicator of systemic inflammation, has been considered to be a predictor of cardiovascular and all-cause mortality in hemodialysis patients. The present study aims to investigate the relationship between NLR and long-term outcome in PD patients. Materials and Methods: The study included patients who initiated PD for at least 3 months between January 1, 2013, and December 31, 2015. All the patients were followed up until death, cessation of PD, or to the end of the study (June 31, 2018). NLR was calculated as the ratio of neutrophils to lymphocytes. Results: A total of 140 patients were included in this study. The median NLR reported was 2.87. Patients with lower NLR showed a higher survival rate than patients with higher NLR (log rank 6.886, p = 0.009). Furthermore, patients with higher NLR had a significantly higher cardiovascular mortality (log rank 5.221, p = 0.022). Multivariate Cox proportional hazards model showed that older age (HR 1.054, 95% CI 1.017–1.092, p = 0.004), higher Ca × P (HR 1.689, 95% CI 1.131–2.523, p = 0.010), and higher NLR (HR 2.603, 95% CI 1.037–6.535, p = 0.042) were independent predictors of increased all-cause mortality. NLR was also independently associated with cardiovascular mortality (HR 2.886, 95% CI 1.005–8.283, p = 0.039). Higher NLR (HR 2.667, 95% CI 1.333–5.337, p = 0.006), older age (HR 1.028, 95% CI 1.005–1.052, p = 0.016), and history of cardiovascular disease (HR 1.426, 95% CI 1.195–3.927, p = 0.031) were significantly independently associated with poor peritonitis-free survival in this study. Conclusions: NLR could be a strong predictor of long-term outcome in PD patients.

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Pulmonary Artery Hypertension as A Risk Factor for Long-Term Survival after Heart Transplantation

The Heart Surgery Forum ◽

10.1532/hsf.3789 ◽

2021 ◽

Vol 24 (3) ◽

pp. E544-E549

Author(s):

Milos Matkovic ◽

Vladimir Milicevic ◽

Ilija Bilbija ◽

Nemanja Aleksic ◽

Marko Cubrilo ◽

...

Keyword(s):

Pulmonary Artery ◽

Cox Regression ◽

Pulmonary Artery Hypertension ◽

Heart Catheterization ◽

Hemodynamic Parameters ◽

Term Outcome ◽

Term Survival ◽

Long Term Outcome ◽

Cox Regression Analysis

Background: Heart failure is the most frequent cause of pulmonary artery hypertension (PAH) and its severity may predict the development of heart failure (HF) and is known to be a prognostic factor of poor outcome after heart transplant (HTx). The aim of this study was to investigate the impact of preoperative PAH related to left-sided HF on long-term survival after HTx and to identify the hemodynamic parameters of PAH that predict survival after HTx. Methods: A prospective observational trial was performed, and it included 44 patients subjected to heart transplantation. Patients were divided into two groups: The first one with the preoperative diagnosis of PAH and the second one without the PAH diagnosed prior to the HTx. The two groups were compared for baseline characteristics, operative characteristics, survival, and hemodynamic parameters obtained by right heart catheterization. Survival was analyzed using Kaplan Meyer analysis, and Cox regression analysis was performed to determine independent predictors of survival. Results: The median follow-up time was 637.4 days (1-2028 days). The median survival within the group of patients with preoperative PAH was 1144 days (95% CI 662.884-1625.116) and 1918.920 days (95% CI 1594.577-2243.263) within the group of patients without PAH (P = .023), HR 0.279 (95% [CI]: 0.086-0.910; P = .034. The 30-day mortality in patients within PAH group was significantly higher, six versus two patients in the non PAH group (χ2 = 5.103, P < .05), while the long-term outcome after this period did not differ between the groups. Patients with preoperative PAH had significantly higher values of MPAP, PCWP, TPG and PVRI, while CO and CI did not differ between the two groups. Mean PVRI was 359.1 ± 97.3 dyn·s·cm-5 in the group with preoperative PAH and 232.2 ± 22.75 dyn·s·cm-5 in the group without PAH, P < .001. TPG values were 11.95 ± 5.08 mmHg in the PAH group while patients without PAH had mean values of 5.16 ± 1.97 mmHg, P < .001. Cox regression analysis was done for the aforementioned parameters. Hazard ratio for worse survival after HTx for elevated values of PVRI was 1.006 (95% [CI]: 1.001-1.012; P = .018) TPG had a hazard ratio of 1.172 (95% [CI]: 1.032-1.233; P = .015). Conclusion: Pulmonary artery hypertension is an independent risk factor for higher 30-day mortality after HTx, while it does not affect the long-term outcome. Hemodynamic parameters obtained by right heart catheterization in heart transplant candidates could predict postoperative outcome. PVRI and TPG have been identified as independent predictors of higher 30-day postoperative mortality.

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