Pulmonary vascular disease & thromboembolism

3-Year Outcome in Patients With Combined Precapillary and Postcapillary Pulmonary Hypertension: Results From PADN-5 Trial

JACC Heart FailPublished Randomised controlled trial

Primary result · Clinical worseningResult — go to the resultHazard ratio 2.13 95% CI 1.19–3.81

Authors' conclusion

PADN is associated with significant improvements in exercise capacity, cardiac function, and clinical outcomes.

Study context

Population
Patients with CpcPH (mean PAP ≥25 mm Hg, PCWP >15 mm Hg, PVR >3.0 WU) secondary to left HF
Participants
98 patients
Comparison
Pulmonary artery denervation (PADN) vs sham + sildenafil
Primary endpoint
Clinical worsening (cardiopulmonary death, rehospitalization or heart/lung transplantation)
Follow-up
3-year follow-up
Methodological detailssham-controlled
  • Sham-controlled

Primary result

Clinical worsening · 3 years

Hazard ratio

2.13

95% CI 1.19–3.81

P = 0.011

Events by treatment group

Sham + sildenafil vs PADN
HR 2.13 (95% CI 1.19–3.81); P = 0.011

As reported in the abstract

Further findings

OutcomePADNSham + sildenafilHR (95% CI)P value
Rehospitalization · 3 years35.4%56.2%1.96 (1.07–3.58)P = 0.029

Cardiopulmonary death · end of study

P = 0.167

6-minute walk distance and NT-proBNP

Greater increase in 6-minute walk distance and reduction in NT-proBNP with PADN

Original publication

3-Year Outcome in Patients With Combined Precapillary and Postcapillary Pulmonary Hypertension: Results From PADN-5 Trial. JACC Heart Fail. Published 21 June 2023. doi:10.1016/j.jchf.2023.05.016

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