Author + information
- Goutham Karuppiah,
- Emily Liu,
- Julian Neshewat,
- Amanda Wasserman,
- Susanne McDevitt,
- Victor Moles,
- Amber Young,
- Dinesh Khanna and
- Vallerie V. McLaughlin
Systemic sclerosis (SSc) is a connective tissue disease that leads to pulmonary arterial hypertension (PAH) in 8–12% of all cases. Because SSc-PAH patients have a worse prognosis compared to idiopathic PAH, early detection and treatment are critical to optimize outcomes. DETECT is a highly predictive risk-score screening algorithm that identifies SSc patients at risk of developing PAH. If the score is above a specific threshold, the patient is referred for a right heart catheterization (RHC) which is required for a definitive diagnosis of PAH. Our goal was to assess the impact of the DETECT score on the severity of SSc-PAH at the time of diagnosis.
Demographic, clinical, and hemodynamic data were compared between two patient cohorts: one diagnosed without DETECT and one diagnosed routinely using DETECT. Data from 83 SSc-PAH historical routine care patients previously reported in the literature between 1996 and 2010 (pre-DETECT) and 48 patients between 2017 and 2018 (post-DETECT) with data abstracted from the University of Michigan (UM) PH database were used in the analysis.
The post-DETECT population included a greater number of patients classified as World Health Organization functional class I and II at baseline compared to pre-DETECT patients (52.1% v. 15.6%; p<0.001). Post-DETECT patients had a higher mean 6-minute walk (6MW) distance (365.4 ± 134.5 v. 285.8 ± 124.1; p<0.001), lower pulmonary vascular resistance (5.4 ± 4.1 v. 10.1 ± 4.5; p<0.001), lower mean pulmonary arterial pressure (34.5 ± 11.8 v. 47.6 ± 10.9; p<0.001), and lower forced vital capacity/diffusing capacity for carbon monoxide ratio (1.6 ± 0.46 v. 2.2 ± 0.85; p<0.001).
The routine usage of the DETECT score in a tertiary referral Scleroderma center led to the diagnosis of SSc-PAH at earlier stages of the disease as evidenced by better functional class, 6MW, and hemodynamics when compared to a historic cohort. This suggests that DETECT is a beneficial tool to promote earlier diagnosis of SSc-PAH.
Sunday, March 29, 2020, 8:12 a.m.-8:22 a.m.
Session Title: Highlighted Original Research: Pulmonary Hypertension and the Year in Review
Abstract Category: 35. Pulmonary Hypertension
Presentation Number: 904-04
- 2020 American College of Cardiology Foundation