Application of the REVEAL risk score calculator 2.0 in the PATENT study
Application of the REVEAL risk score calculator 2.0 in the PATENT study
复制标题
DOI：
10.1016/j.ijcard.2021.03.034
复制
发表时间：
2021-04-29
影响因子：
3.5
通讯作者：
Hoeper, Marius M.
中科院分区：
文献类型：
--
作者：
Benza, Raymond L.;Farber, Harrison W.;Hoeper, Marius M.
背景：建议在肺动脉高压（PAH）管理中进行定期风险评估，以改善患者结局。REVEAL风险评分（RRS）可预测PAH患者的生存期，包括来自PATENT研究的患者，该研究评估了批准用于PAH治疗的可溶性鸟苷酸环化酶刺激剂利奥西呱。一个更新的版本，RRS 2.0，已经开发出进一步完善risk predict.Methods：这事后分析的专利-1及其开放标签扩展专利-2（n = 396）评估RRS 2.0评分和风险分层及其与生存和临床无瘤生存期（CWFS）。结果如下：在PATENT-1第12周，与安慰剂相比，利奥西呱改善了RRS 2.0（与安慰剂相比的最小二乘均值差：-1.0 [95%置信区间-1.4至-0.6; p < 0.0001]），与安慰剂（42%）相比，利奥西呱改善风险分层的患者更多（57%）。这些改善在PATENT-2第12周得以维持。PATENT-1基线和第12周的RRS 2.0评分和风险分层与PATENT-2中的生存期和CWFS显著相关（p < 0.0001）;从PATENT-1基线到第12周RRS 2.0评分的变化也与结局显著相关。这些数据表明，RRS 2.0在预测PAH患者的长期结局和监测治疗反应方面具有临床实用性。(c)2021年，任作家。由爱思唯尔公司出版。这是一篇开放获取的文章，使用CC BY-NC-ND许可证（http：//creativecommons.org/licenses/by-nc-nd/4.0/）。
Background: Regular risk assessment is recommended in pulmonary arterial hypertension (PAH) management to improve patient outcomes. The REVEAL risk score (RRS) predicts survival in patients with PAH, including those from the PATENT study, which assessed riociguat, a soluble guanylate cyclase stimulator approved for PAH treatment. An updated version, RRS 2.0, has been developed to further refine risk prediction.Methods: This post hoc analysis of PATENT-1 and its open-label extension PATENT-2 (n = 396) assessed RRS 2.0 score and risk stratum and their association with survival and clinical worsening-free survival (CWFS). Results: At PATENT-1 Week 12, riociguat improved RRS 2.0 versus placebo (least-squares mean difference versus placebo: -1.0 [95% confidence interval - 1.4 to -0.6; p < 0.0001]) and more patients improved risk stratum with riociguat (57%) versus placebo (42%). These improvements were maintained at PATENT-2 Week 12. RRS 2.0 score and risk strata at PATENT-1 baseline and Week 12 were significantly associated with survival and CWFS in PATENT-2 (p < 0.0001); change in RRS 2.0 score from PATENT-1 baseline to Week 12 was also signifi-cantly associated with outcomes.Conclusions: These data suggest that RRS 2.0 has clinical utility in predicting long-term outcomes and monitoring treatment response in patients with PAH.(c) 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).