Outcomes of Pulmonary Arterial Hypertension are Improved in a Specialty Care Center

Abstract Background Pulmonary arterial hypertension (PAH) is characterized by elevated pulmonary arterial pressures managed by vasodilator therapies. Current guidelines encourage PAH management in specialty care centers (SCCs), but evidence is sparse regarding improvement in clinical outcomes and correlation to vasodilator use with referral. We hypothesize that PAH management at SCCs is associated with improved clinical outcomes. Methods A single-center, retrospective study was performed at UPMC (overseeing 40 hospitals). PAH patients were identified between 2008-2018 and classified into a SCC or non-SCC cohort. Cox proportional hazard model was compared for all-cause mortality and negative binomial regression modeling for hospitalizations. Vasodilator therapy was included to adjust outcomes. Result Of 580 PAH patients at UPMC, 455 (78%) were managed at the SCC, comprising a younger (58.8 vs. 64.8 years, p 0.05). Conclusion The UPMC SCC demonstrated improved outcomes in mortality and hospitalizations. SCC Benefit was multifactorial, with more frequent vasodilator therapy and disease monitoring. These findings provide robust evidence for early and regular referral of PAH patients to SCCs.