Discrimination Ability of PAH Risk Scores Drops in Intermediate-Risk Populations
Although current scores to differentiate risk in the overall pulmonary arterial hypertension (PAH) population are adequate, their risk discrimination in intermediate groups is lower, according to a new systematic review.
“Despite improvement in risk estimation of prognostic tools of the disease, pulmonary arterial hypertension morbidity and mortality remain high, necessitating the need for the risk scores to undergo periodic re-evaluation and refinements to incorporate new data on predictors of disease progression and mortality and, thereby, maintain their clinical utility,” the researchers wrote.
Their systematic review included a total 25 studies on prognostic models and scores for patients with PAH. Among them, 9 studies derived prognostic equations and risk scores, and 16 validated existing scores.
To assess patient prognosis, most risk stratification scores rely on hemodynamic data, the researchers reported, though some scores also factor in clinical and demographic variables.
For differentiating low-risk patients from high-risk patients, existing scores are adequate, according to the review. However, their discrimination ability is not as strong in intermediate groups.
The researchers also pointed out that risk stratification scores proposed by the European Society of Cardiology/European Respiratory Society contain a limited number of parameters that have had their prognostic significance validated in European patient populations.
Mouratoglou SA, Bayoumy AA, Noordegraaf AV. Prediction models and scores in pulmonary hypertension: a systematic review. Curr Pharm Des. Published online November 5, 2020. https://doi.org/10.2174/1381612824999201105163437