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Application of the REVEAL risk score calculator 2.0 in the PATENT study

Lookup NU author(s): Emeritus Professor Nick Europe-Finner



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


© 2021 The AuthorsBackground: 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 significantly 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.

Publication metadata

Author(s): Benza RL, Farber HW, Frost AE, Ghofrani H-A, Corris PA, Lambelet M, Nikkho S, Meier C, Hoeper MM

Publication type: Article

Publication status: Published

Journal: International Journal of Cardiology

Year: 2021

Volume: 332

Pages: 189-192

Print publication date: 01/06/2021

Online publication date: 17/03/2021

Acceptance date: 14/03/2021

Date deposited: 13/04/2021

ISSN (print): 0167-5273

ISSN (electronic): 1874-1754

Publisher: Elsevier Ireland Ltd.


DOI: 10.1016/j.ijcard.2021.03.034

PubMed id: 33744348


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