The Pursuit of Risk Assessment and Stratification Tools in Pulmonary Arterial Hypertension: Have We Seen the Lite?

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Initial and ongoing risk assessment in pulmonary arterial hypertension (PAH) is key in determining class and intensity of PAH-specific therapy, discussing prognosis, and optimizing timing for lung transplant referral. Treatment guidelines advocate for achievement and maintenance of low-risk status. In the last decade, tools to assess risk systematically have emerged, with the use of objective metrics beyond clinician gestalt. These instruments are derived from large clinical registries. Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL), a prospective study of >3,500 patients in the United States, led to the development of the first REVEAL Registry risk calculator (REVEAL 1.0).