Pulmonary vascular disease & thromboembolism
Refining the Definition for “Low Risk” in Pulmonary Arterial Hypertension: Time to Reduce Morbidity and Mortality
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
Methodological detailsharmonized data set of 8 RCTs
- Harmonized data set of 8 RCTs
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% |
REVEAL 2.0 ≤4
3-year mortality2.6%
1-year clinical worsening6.4%
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: Time to Reduce Morbidity and Mortality. JACC Heart Fail. Published 22 May 2026. doi:10.
Summarised from the published abstract; every number is checked against it