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Published on: June 27, 2025
Risk stratification in pulmonary arterial hypertension
Jason Weatherald1,2, Athénaïs Boucly3,4,5, Olivier Sitbon3,4,5
1Division of Respirology, Department of Medicine, University of Calgary.
Periodic risk stratification is crucial for pulmonary arterial hypertension (PAH) patients. Tools like the REVEAL score and ESC/ERS risk table offer multidimensional prognostic estimates, aiding clinical management.
Area of Science:
- Cardiology
- Pulmonology
- Medical Prognostics
Background:
- Pulmonary arterial hypertension (PAH) necessitates regular risk assessment for optimal patient management.
- Accurate prognostication is vital for guiding treatment strategies in PAH.
Purpose of the Study:
- To review and summarize current risk stratification tools for pulmonary arterial hypertension (PAH).
- To highlight the utility of validated multidimensional risk assessment in clinical practice.
Main Methods:
- Review of validated risk stratification tools, including the REVEAL score and ESC/ERS risk assessment table.
- Analysis of data from REVEAL and European registries to validate prognostic factors.
- Evaluation of serial risk assessment versus single time-point assessment.
Main Results:
- The REVEAL score and ESC/ERS risk table integrate clinical, exercise, imaging, and hemodynamic data for comprehensive prognosis.
- Serial risk assessment, particularly changes in risk profile, offers greater clinical insight.
- A simplified ESC/ERS low-risk criteria count (3-4 criteria) indicates an excellent prognosis.
- The REVEAL score categorizes patients into five risk groups with distinct 1-year survival rates.
Conclusions:
- The REVEAL score and ESC/ERS risk table are validated, multidimensional tools essential for periodic risk stratification in PAH patients.
- Regular application of these tools aids in refining treatment decisions and improving patient outcomes.
- Understanding prognostic factors and risk profiles is key to managing PAH effectively.
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