Paper of the Month - July, 2012

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The REVEAL registry risk score calculator in patients newly diagnosed with pulmonary arterial hypertension.

Benza RL, Gomberg-Maitland M, Miller DP et al.
REVEAL (Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension) is the largest US registry for pulmonary arterial hypertension (PAH). Data from 2716 (78.6% female) newly diagnosed or previously treated individuals with PAH aged 50±17 years enrolled before September 2007 revealed the following variables to be independently associated with increased mortality in patients with group 1 PAH: male gender, age >60 years, familial PAH, PAH associated with portal hypertension or connective tissue disease, family history of PAH, World Health Organization (WHO) functional class III or IV, renal insufficiency, resting systolic blood pressure <110 mmHg, heart rate >92 beats/min, mean right atrial pressure >20 mmHg, 6-min walk distance (6MWD) <165 m, brain natriuretic peptide (BNP) level >180 pg/mL, pulmonary vascular resistance >32 WU, percent predicted diffusing capacity of lung for carbon monoxide (DLCO) ≤32%, and the presence of pericardial effusion on echocardiogram (Circulation 2010;122:164–72).