Prognostic Value of Catestatin and Thrombospondin in Patients with Pulmonary Hypertension: Treatment Escalation as a Means of Improving Quality of Life

Background: Pulmonary hypertension (PH) is a progressive disease characterized by increased pulmonary vascular resistance and right heart failure. Despite advances in therapy, prognosis remains poor, highlighting the need for novel prognostic biomarkers. Objective: This scoping review aims to assess the prognostic value of catestatin and thrombospondin in patients with pulmonary hypertension and to examine how treatment escalation strategies affect patients' quality of life. Methods: This scoping review was conducted in accordance with the PRISMA-ScR guidelines. We searched databases such as PubMed, Scopus, Web of Science, and Embase for studies published between 2010 and 2024. The inclusion criteria encompassed original research articles evaluating the prognostic potential of catestatin and thrombospondin in PH patients. Data extraction focused on biomarker expression, survival outcomes, treatment escalation, and quality of life metrics. Results: Out of 348 records identified, 27 studies met the eligibility criteria. Both catestatin and thrombospondin showed significant correlations with clinical deterioration and right ventricular dysfunction. Several studies indicated that treatment escalation guided by biomarker levels contributed to better long-term outcomes and improved quality of life. Conclusions: Catestatin and thrombospondin may serve as promising prognostic biomarkers in pulmonary hypertension. Their utility in guiding treatment escalation warrants further clinical validation. Early identification of high-risk patients could improve prognosis and quality of life.