A new risk prediction score (RPS) may be used to estimate the risk of pulmonary hypertension (PH) in patients who have systemic sclerosis (SSc). The "Cochin RPS" is based on simple examinations recommended in the routine treatment of patients with SSc.
Meune and associates looked at the prevalence and characteristics of precapillary PH confirmed by right heart catheterization in a cross-sectional (derivation) sample of patients. They externally validated their score in a separate, prospectively enrolled sample of patients who were free from SSc at baseline.
In the derivation sample, independent predictors of PH that emerged—age, forced vital capacity, and diffusing capacity for carbon monoxide/alveolar volume—were used to create the Cochin RPS. In the validation sample, a diagnosis of precapillary PH was made in 20 of 443 patients. The overall predictive value of the Cochin RPS was 0.87. The use of 2.73 as a cutoff value resulted in 89.5% sensitivity and 74.1% specificity in detecting patients with PH during follow-up. The risk in patients in the highest quintile was more than 35-fold higher than in those in the 2 lowest quintiles.
The authors noted that their score detected a subgroup of patients in whom isolated pulmonary arterial hypertension would develop.
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