PTGIR and pulmonary arterial hypertension: The decrease in ASR values for deaths and DALYs may primarily stem from the widespread application of multi-drug combination therapies (combined with the efficacy of phosphodiesterase type-V inhibitors (PDE-Vi), endothelin type-A, and type-Vi) (38), new drugs [including endothelin type-A and type-B receptor antagonists (ERAs), prostaglandin I2, and the GRIPHON trial with selexipag (a prostaglandin I2 receptor agonist)] (40–42), and advances in basic research on PAH-related biomarkers (HGFA) (43).