The Research: Evidence on the predictive ability of risk assessment models for event-free survival (EFS) in patients with pulmonary arterial hypertension is scarce, say the authors of a recent study published on Pulmonary Circulation. The aim of the study was to evaluate how well three different risk assessment models predict event-free survival. The study included 411 patients with pulmonary arterial hypertension from a Swedish registry between 2008-2021. The three risk models tested were: 1) Multicomponent Improvement (MCI) 2) European Society of Cardiology/European Respiratory Society 4-Strata Risk 3) non-invasive French Pulmonary Hypertension Registry Score. Event-free survival was defined as survival without pulmonary arterial hypertension-related hospitalization, starting parenteral prostacyclin therapy or increasing the dose by 10% or more, or lung transplantation. The median age of patients was 66 years, with 70% being women; younger patients (under 65) had fewer health conditions and better exercise tolerance than older patients.
The Results: All three risk assessment models successfully predicted event-free survival when applied 6 months after diagnosis, with patients classified as lower risk having better outcomes. The 4-Strata Risk and French Registry Score models were more accurate predictors than the Multicomponent Improvement model. Patients classified as high risk had a median event-free survival of less than 1 year across all risk models, highlighting the need for intensive treatment. Pulmonary artrial hypertension-related hospitalizations were very common, with 278 occurring during the study period; higher-risk patients experienced more hospitalizations. Younger patients received more aggressive treatment with combination therapies and had better outcomes overall compared to older patients. Atrial fibrillation was found to be an independent predictor of hospitalization, affecting 22% of patients aged 65 and older.
- The study demonstrates that performing risk assessments 6 months after diagnosis can effectively predict patient outcomes and help guide treatment decisions.
- The findings support the importance of early identification of high-risk patients and prompt intervention to prevent disease progression and improve long-term survival.
Summary by Suzanne Lea, AfPH volunteer
Citation
Hjalmarsson C, Thakur T, Rådegran G, Björklund E, Wåhlander H, Nisell M, Papageorgiou JM, Söderberg S, Lautsch D, Kjellström B. Risk Assessment Models and Event-Free Survival in Pulmonary Arterial Hypertension. Pulm Circ. 2025 Jul 18;15(3):e70132. doi: 10.1002/pul2.70132. PMID: 40687338; PMCID: PMC12272513.
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