Idiopathic pulmonary arterial hypertension (PAH) is a rare disease with poor prognosis. New kind of therapy have improved the outcome of this condition and accordingly the factors that determine the outcome may have been reconsidered. The author aimed at identifying determinants of survival in a cohort of 25 patients with familial, idiopathic or associated with anorexigens PAH. One, two and three year survival has been observed in 87%, 75% and 61% of cases respectively. Warfarin use has been associated with a reduced risk of death, hypoalbuminemia--with the increased one. Higher cardiac index and acute vasoreactivity were independently associated with improved survival. These data suggest that the determinants of the outcome have been changed since 1991.