Pulmonary vascular disease & thromboembolismMeta-analysis
Refining the Definition for “Low Risk” in Pulmonary Arterial Hypertension
- Pooled patient-level analysis of randomised controlled trials
- harmonized data set of 8 RCTs
Authors' conclusion
This study is the first to embed both morbidity and mortality within the definition of low -risk for PAH and suggests that patients with a REVEAL 2.0 risk score ≤4 define this condition.
Study context
- Population
- Pulmonary arterial hypertension (PAH) patients with REVEAL 2.0 risk score ≤6 (low risk by contemporary scores) in 8 RCTs
- Participants
- 1,925 patients · 8 RCTs
- Comparison
- REVEAL 2.0 score ≤4 vs 5 or 6
- Outcome
- Refined low risk: risk of death <5% at 3 years and risk of clinical worsening <10% at 1 year
Pooled result
As reported in the abstract
Refined low risk
| Group | 3-year mortality | 1-year clinical worsening |
|---|---|---|
| REVEAL 2.0 ≤4 | 2.6% | 6.4% |
Further pooled results
Factors associated with refined low risk
- Idiopathic PAH, 6MWD, NT-proBNP, NYHA class I to II, heart rate and absence of previous AF associated with refined low risk
Original publication
Refining the Definition for “Low Risk” in Pulmonary Arterial Hypertension. JACC Heart Fail. Published 22 May 2026. doi:10.1016/j.jchf.2026.103151
Summarised from the published abstract; every number is checked against it