• Jason H Karnes, Howard W Wiener, Tae-Hwi Schwantes-An, Balaji Natarajan, Andrew J Sweatt, Abhishek Chaturvedi, Amit Arora, Ken Batai, Vineet Nair, Heidi E Steiner, Jason B Giles, Jeffrey Yu, Maryam Hosseini, Michael W Pauciulo, Katie A Lutz, Anna W Coleman, Jeremy Feldman, Rebecca Vanderpool, Haiyang Tang, GarciaJoe G NJGNDepartment of Medicine, University of Arizona, Tucson, Arizona., Jason X-J Yuan, Rick Kittles, Vinicio de Jesus Perez, Roham T Zamanian, Franz Rischard, Hemant K Tiwari, William C Nichols, Raymond L Benza, and Ankit A Desai.
• Department of Pharmacy Practice and Science.
• Am. J. Respir. Crit. Care Med. 2020 Jun 1; 201 (11): 140714151407-1415.

AbstractRationale: Limited information is available on racial/ethnic differences in pulmonary arterial hypertension (PAH).Objectives: Determine effects of race/ethnicity and ancestry on mortality and disease outcomes in diverse patients with PAH.Methods: Patients with Group 1 PAH were included from two national registries with genome-wide data and two local cohorts, and further incorporated in a global meta-analysis. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for transplant-free, all-cause mortality in Hispanic patients with non-Hispanic white (NHW) patients as the reference group. Odds ratios (ORs) for inpatient-specific mortality in patients with PAH were also calculated for race/ethnic groups from an additional National Inpatient Sample dataset not included in the meta-analysis.Measurements and Main Results: After covariate adjustment, self-reported Hispanic patients (n = 290) exhibited significantly reduced mortality versus NHW patients (n = 1,970) after global meta-analysis (HR, 0.60 [95% CI, 0.41-0.87]; P = 0.008). Although not significant, increasing Native American genetic ancestry appeared to account for part of the observed mortality benefit (HR, 0.48 [95% CI, 0.23-1.01]; P = 0.053) in the two national registries. Finally, in the National Inpatient Sample, an inpatient mortality benefit was also observed for Hispanic patients (n = 1,524) versus NHW patients (n = 8,829; OR, 0.65 [95% CI, 0.50-0.84]; P = 0.001). An inpatient mortality benefit was observed for Native American patients (n = 185; OR, 0.38 [95% CI, 0.15-0.93]; P = 0.034).Conclusions: This study demonstrates a reproducible survival benefit for Hispanic patients with Group 1 PAH in multiple clinical settings. Our results implicate contributions of genetic ancestry to differential survival in PAH.

22 keywords...

hide…