Abstract 14339: Guideline-Directed Intensive Management Improves Long-Term Survival and Compliance of Pulmonary Hypertension Patient

Introduction: Although the overall survival of PH patients improved in the current era, better management of PH patients still needs further exploration.

Hypothesis: We hypothesized that guideline-directed, nurse-led, and multidisciplinary intensive management of PH patients would improve the overall survival of PH patients.

Methods: We prospectively enrolled patients with PH from October 2013 to December 2020. Patients were divided into intensive management group and usual care group voluntarily. Intensive management was nurse-led and delivered by multidisciplinary teams, including patient education, symptoms monitoring, and patient adherence improvement with careful outpatient assessment every 3 months and medicine prescription whenever needed. Patients with usual care were treated by primary cardiologists’ consultants and telephone follow-ups every year.

Results: Overall, 413 PH patients were finally included with a median follow-up period of 25.2 months(interquartile range: 12.4-44.3 months). Both overall survival (p<0.001) and event-free survival (p=0.008) of the intensive management group were significantly higher than the usual care group. After adjustment of age and sex, intensive management was also an independent protective predictor for both primary [all-cause mortality, HR 0.378, 95% CI (0.214-0.668), p<0.001] and composite endpoints [all-cause mortality and re-hospitalization, HR 0.648, 95% CI (0.454-0.927), p=0.017].

Conclusions: Guideline-directed, nurse-led, multidisciplinary intensive disease management strategy could be an ideal method to further improve the overall survival and event-free survival of PH patients.