In a recent study entitled “Prognostic implications of serial risk score assessments in patients with pulmonary arterial hypertension: A Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL) analysis” researchers determined how changes in risk scores in patients with Pulmonary Arterial Hypertension impact their disease prognosis. The study was published in The Journal of Heart and Lung Transplantation.
In this new research project, researchers used data retrieved from the Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL), previously developed to provide a mathematical prognosticator for one-year survival in patients with Pulmonary Arterial Hypertension, to determine if the REVEAL risk score is still an effective predictor of patients’ survival over time. To this end, authors grouped RISK enrolled patients according to their score (taking into consideration the REVEAL risk score determined at the time of patients’ enrollment) and recalculated it from the most recent assessments, 12 months after enrollment. This recalculation led to three score categories — decreased, unchanged, or increased risk scores. Subsequently, they estimated patients’ 1-year survival based on alterations to the risk score.
Authors analyzed 2,529 patients in total, and observed score decrease in 800 patients, while the opposite was observed in 770 patients at 12 months post-enrollment. Unchanged scores were observed in 800 patients for the same period. The parameters evaluated — functional class, systolic blood pressure, heart rate, 6-minute walk distance, brain natriuretic peptide levels, and pericardial effusion – varied with time in more than 5% of the patients. When evaluating how changes in the risk score affected patients’ survival, the team observed that these significantly predicted patients’ future survival. In the study, authors estimated one-year survival after 12 months at 93.7% (patients with decreased risk score), 90.3% (unchanged score) and 84.6% (increased risk score).
According to their results, authors noted that follow-up risk revealed a much stronger predictor of patients’ future survival when compared to risk at enrollment. Notably, however, this later parameter still has a significant predictive value for future survival. The authors suggest serial risk score assessments are an efficient strategy to identify changes that may lead to treatment modifications to better suit patients’ disease progression.