Presentation Outline ICHP Annual Meeting September 13-15

Cummulative
suurvival
Survival in IPAH
Long-term CCB Responders
1.0
0.8
0.6
04 0.4
0.2
0.0
Subjects
at risk, n
Long-term CCB responders (~50% of acute
responders or ≤6% of IPAH patients)
p=0.0007
Long-term CCB failure
0 2 4 6 8 10 12 14 16 18
Years
38 33 30 22 13 8 3 3 2 1
19 12 7 4 0
Sitbon O, et al. Circulation. 2005;111:3105-3111.
Long-term CCB
responders
Long-term CCB
failure
What Is the Optimal Treatment Strategy?
Anticoagulate ± Diuretics ±
Oxygen ± Digoxin
Oral CCB
Positive
McLaughlin VV, et al. J Am Coll Cardiol. 2009;53:1573-1619.
Acute Vasoreactivity Testing
Negative
No LOWER RISK DETERMINANTS OF RISK HIGHER RISK
No Clinical evidence of RV failure Yes
Sustained
Gradual Progression of symptoms Rapid
Response
II, III WHO class IV
Longer (>400 m) 6MWD Shorter (10.4 mL/kg/min CPET Peak VO2 20 mm Hg;
CI 400 ( m) ) 6MWD Shorter (10.4 mL/kg/min CPET Peak VO 2 20 mm Hg;
CI