A multicenter study of anticoagulation in operable chronic thromboembolic pulmonary hypertension

Background Chronic thromboembolic pulmonary hypertension (CTEPH) is an uncommon complication of acute pulmonary emboli necessitating lifelong anticoagulation. Despite this, few data exist on the safety and efficacy of vitamin K antagonists (VKAs) in CTEPH and none for direct oral anticoagulants (DOA...

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Veröffentlicht in:	Journal of thrombosis and haemostasis 2020-01, Vol.18 (1), p.114-122
Hauptverfasser:	Bunclark, Katherine, Newnham, Michael, Chiu, Yi‐Da, Ruggiero, Alessandro, Villar, Sofia S., Cannon, John E., Coghlan, Gerry, Corris, Paul A., Howard, Luke, Jenkins, David, Johnson, Martin, Kiely, David G., Ng, Choo, Screaton, Nicholas, Sheares, Karen, Taboada, Dolores, Tsui, Steven, Wort, Stephen John, Pepke‐Zaba, Joanna, Toshner, Mark
Format:	Artikel
Sprache:	eng
Schlagworte:	Administration, Oral Antagonists anticoagulant Anticoagulants Anticoagulants - adverse effects Bleeding complications Health risk assessment Hemodynamics Humans Hypertension Hypertension, Pulmonary - diagnosis Hypertension, Pulmonary - drug therapy Medical records Pulmonary hypertension Retrospective Studies Thromboembolism venous thromboembolism Venous Thromboembolism - complications Venous Thromboembolism - diagnosis Venous Thromboembolism - drug therapy Vitamin K Vitamin K - therapeutic use warfarin
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Zusammenfassung:	Background Chronic thromboembolic pulmonary hypertension (CTEPH) is an uncommon complication of acute pulmonary emboli necessitating lifelong anticoagulation. Despite this, few data exist on the safety and efficacy of vitamin K antagonists (VKAs) in CTEPH and none for direct oral anticoagulants (DOACs). Objectives To evaluate outcomes and complication rates in CTEPH following pulmonary endarterectomy (PEA) for individuals receiving VKAs or DOACs. Methods Consecutive CTEPH patients undergoing PEA between 2007 and 2018 were included in a retrospective analysis. Postoperative outcomes, recurrent venous thromboembolism (VTE), and bleeding events were obtained from patient medical records. Results Seven hundred ninety‐four individuals were treated with VKAs and 206 with DOACs following PEA. Mean observation period was 612 (standard deviation: 702) days. Significant improvements in hemodynamics and functional status were observed in both groups following PEA (P
ISSN:	1538-7933 1538-7836 1538-7836
DOI:	10.1111/jth.14649