The albumin-bilirubin score predicts severity and long-term outcomes in patients with chronic thromboembolic pulmonary hypertension

Abstract Background -2.6, respectively. A high ALBI score, compared to a low ALBI score, was associated with a shorter six-minute walk distance (162.1±134.1 vs. 233.6±145.7, p0.001), a higher frequency of WHO functional class III/IV status, higher NT-ProBNP levels (4626.2±6785.6 vs. 2426.2±4051.9, p=0.003), and lower aortic and mixed venous oxygen saturations (89.9±7.3% vs. 92.2±4.8%, p=0.005 and 58.4±10.3% vs. 62.5±8.2%, p0.001) at baseline assessment. The high ALBI group was more likely to be classified as intermediate- or high-risk according to the ESC/ERS 2022 baseline risk score, COMPERA 3-strata, REVEAL 2.0, REVEAL Lite 2.0, and the four-component French Registry score at baseline evaluation. The median and mean follow-up durations were 313 days (IQR: 68.5-863) and 560 ± 631 days, respectively. The low ALBI group had significantly higher Kaplan-Meier survival estimates at 1 year (93.3% vs. 70.3%), 3 years (93.3% vs. 71.8%), and 5 years (93.3% vs. 34%). Conclusions The ALBI score at the time of diagnosis appears to be associated with clinical, neurohormonal, and hemodynamic markers of disease severity, risk status as assessed by multiparametric scoring models, and long-term outcomes in patients with CTEPH.Characteristics of two ALBI groups Survival plot