Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Epidemiology of PAH in Korea: An Analysis of the National Health Insurance Data, 2002-2018

  • Albert Youngwoo Jang (Gachon Cardiovascular Research Institute, Gachon University) ;
  • Hyeok-Hee Lee (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Hokyou Lee (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Hyeon Chang Kim (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Wook-Jin Chung (Gachon Cardiovascular Research Institute, Gachon University)
  • Received : 2022.08.25
  • Accepted : 2023.01.18
  • Published : 2023.05.01
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Abstract

Background and Objectives: Pulmonary arterial hypertension (PAH) is a rare but fatal disease. Recent advances in PAH-specific drugs have improved its outcomes, although the healthcare burden of novel therapeutics may lead to a discrepancy in outcomes between developing and developed countries. We analyzed how the epidemiology and clinical features of PAH has changed through the rapidly advancing healthcare infrastructure in South Korea. Methods: PAH was defined according to a newly devised 3-component algorithm. Using a nationwide health insurance claims database, we delineated annual trends in the prevalence, incidence, medication prescription pattern, and 5-year survival of PAH in Korea. Cumulative survival and potential predictors of mortality were also assessed among 2,151 incident PAH cases. Results: Between 2002 or 2004 and 2018, the prevalence and incidence of PAH increased 75-fold (0.4 to 29.9 per million people) and 12-fold (0.5 to 6.3 per million person-years), respectively. The proportion of patients on combination PAH-specific drug therapy has also steadily increased up to 29.0% in 2018. Among 2,151 incident PAH cases (median [interquartile range] age, 50 [37-62] years; 67.2% female), the 5-year survival rate and median survival duration were 71.8% and 13.1 years, respectively. Independent predictors of mortality were age, sex, etiology of PAH, diabetes, dyslipidemia, and chronic kidney disease. Conclusions: This nationwide study delineated that the prevalence and incidence of PAH have grown rapidly in Korea since the early 2000s. The use of combination therapy has also increased, and the 5-year survival rate of PAH in Korea was similar to those in western countries.

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Acknowledgement

This work was supported by the Korean Society of Cardiology (2020); the Korea Disease Control and Prevention Agency (grant numbers 2021-ER0902-00, 2021-ER0902-01, 2021-ER0902-02, 2018-ER6304-00, 2018-ER6304-01, 2018-ER6304-02); Gachon University (grant number 202209630001); Gachon University Gil Medical Center (grant number FRD2020-11, grant number FRD2022-05); the Korea Medical Device Development Fund (grant numbers 9991006834, KMDF_PR_20200901_0164, 9991007387, KMDF_PR_20200901_0170) funded by the Korean government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health and Welfare, the Ministry of Food and Drug Safety); the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. NRF-2021R1A5A2030333); The Korean Cardiac Research Foundation (grant number 202103-03); and Asia-pacific Cardiometabolic Society (grant number: 2021-06).

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