However, 5-year survival rates are compromised compared with low-risk patients, underscoring the importance of frequent monitoring and treatment adjustments in this subset of patients and the importance of treating to goal to achieve (and maintain) a low-risk profile1; for example, switching from phosphodiesterase type 5 inhibitors to soluble guanylate cyclase stimulators (based on the REPLACE study) or addition of prostacyclin receptor agonists (based on the Prostacycline ([PGI2]) Receptor Agonist In Pulmonary Arterial Hypertension, or GRIPHON, study).29 The gene discussed is PTGIR; the disease is pulmonary arterial hypertension.