Key result
Established PAH risk scores accurately predict mortality in Hispanic patients with c-statistics up to ~0.77.
Why the study?
Due to the low number of Hispanic patients enrolled in large PAH trials and registries, it was unknown whether established risk stratification tools apply to this population.
Does baseline risk stratification using established models (REVEAL 2.0 and COMPERA) accurately predict mortality in a Hispanic population with pulmonary arterial hypertension?
Cohort (n=135)
No
Does baseline risk stratification using established models (REVEAL 2.0 and COMPERA) accurately predict mortality in a Hispanic population with pulmonary arterial hypertension?
Current guideline-recommended multidimensional risk scores for pulmonary arterial hypertension reliably stratify prognosis in Hispanic populations.
Supports risk stratification with established scores in Hispanic PAH; extends validation to this population but remains hypothesis-generating.
Pulmonary arterial hypertension (PAH) is a cardiovascular disease with high mortality rate. Current guidelines propose initiation and escalation of PAH‐targeted treatment based on a goal‐directed approach targeting hemodynamic, functional, and biochemical variables. This approach has been successfully validated in large Caucasian cohorts. However, given the low number of Hispanic patients enrolled in large PAH trials and registries, it is unknown if the same prognostic tools can be applied to this patient population. We analyzed a single‐center outpatient cohort that consisted of 135 Hispanic patients diagnosed with PAH. Baseline characteristics were calculated based on COMPERA, COMPERA 2.0 and REVEAL 2.0 risk scores before the initiation of PAH‐targeted therapies. The survival rate at 1 year after diagnosis was 88% for the entire cohort. The three established risk scores to predict PAH outcomes yielded similar results with reasonable discrimination of mortality in the different risk strata (all p < 0.001). Hispanic patients with PAH have a high mortality rate. Our analysis suggests that guideline proposed risk assessment at baseline yields important prognostic information in this patient population.
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Fadah et al. (2023) conducted a cohort in Pulmonary arterial hypertension (n=135). Baseline risk stratification (REVEAL 2.0, COMPERA, COMPERA 2.0) was evaluated on Composite of death or lung transplantation (mortality discrimination via c-statistic) (c-statistic 0.77 for REVEAL 2.0, 95% CI 0.69-0.86, p=<0.001). Established risk scores (REVEAL 2.0, COMPERA 1.0, and COMPERA 2.0) accurately discriminated mortality in Hispanic patients with pulmonary arterial hypertension (c-statistics 0.64-0.79).
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