Study: How Does Race Influence PAH Outcomes?
Individuals with pulmonary arterial hypertension (PAH) who have Hispanic or Native American ancestry seem to have inpatient mortality benefit than individuals who are non-Hispanic white, according to a new analysis.
To conduct their analysis, the researchers included data on patients with Group 1 PAH (as defined by the World Health Organization) from 2 national registries with genome-wide data, as well as 2 local cohorts.
A global meta-analysis was performed using the 4 cohort datasets. Results showed that participants who are Hispanic (n=290) had significantly reduced mortality vs participants who are non-Hispanic white (n=1970), after the researchers adjusted for covariates. The hazard ratio was 0.60.
Among participants in the 2 national registries, results of the analysis suggested that Native American genetic ancestry may account for part of the observed mortality benefit, with a hazard ratio of 0.48.
A third cohort from an additional National Inpatient Sample dataset was analyzed for odds ratios for inpatient-specific mortality among the different race/ethnic groups.
Results from that analysis showed that an inpatient mortality benefit was also observed for individuals who are Hispanic (n=1524) vs participants who are non-Hispanic white (n=8829). The odds ratio was 0.65.
Participants who are Native American (n=185) also had an inpatient mortality benefit, with an odds ratio of 0.38.
“This study demonstrates a reproducible survival benefit for Hispanic Group 1 PAH patients in multiple clinical settings,” the researchers concluded. “Our results implicate contributions of genetic ancestry to differential survival in PAH.”
Karnes JH, Wiener HW, Schwantes-An TH, et al. Genetic admixture and survival in diverse populations with pulmonary arterial hypertension [published online January 9, 2020]. Am J Respir Crit Care Med. https://doi.org/10.1164/rccm.201907-1447oc.