Background. COMPERA 2.0 4-strata model has been recommended for risk stratification in PAH. However, its comparison with REVEAL Lite 2.0 is yet to be determined.
Methods. Retrospective analysis from June 2011 to February 2022 of the PAH registry patients from the expert Pulmonary Hypertension Center. Patients were stratified according to REVEAL Lite 2.0, COMPERA 3-, and 4-strata risk scores at baseline to predict the composite outcome of lung transplantation or death. ROC curves in predicting the binary outcome at 3, 5 and 7 years were plotted. Areas Under the Curve (AUC) of the scores were compared by the chi-square test. The performance of the scores was determined by the C-statistic. Agreements between the risk models were determined using Cohen?s kappa statistic (?).
Results. 343 patients were reviewed but 296 were included in the final analysis.  46 were excluded due to missing data. Risk data was available at baseline. Agreements was fair (?: 0.33; p<0.001) between 3-strata model and REVEAL Lite 2.0, and slight (?: 0.18; p<0.001) between REVEAL lite 2.0 and the 4-strata model. ROC curves for outcomes at 3, 5 and 7 years showed a higher AUC for REVEAL Lite 2.0 compared to 4-Strata and 3-Strata models (Figure 1).
Conclusion. At baseline, REVEAL Lite 2.0 showed better discrimination to predict the composite outcome at 3, 5 & 7-years compared to the 3- & 4-strata approaches.