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Use of direct oral anticoagulants for chronic thromboembolic pulmonary hypertension

OBJECTIVES: Chronic thromboembolic pulmonary hypertension is one of the most prevalent forms of pulmonary hypertension and is a major complication of acute pulmonary embolism. One mainstay of chronic thromboembolic pulmonary hypertension treatment is lifelong anticoagulation. The recent advent of di...

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Autores principales: Gavilanes-Oleas, Francisca Alexandra, Alves, Jose Leonidas, Fernandes, Caio Julio Cesar, Prada, Luis Felipe Lopes, Salibe, William, Terra, Mario, Morinaga, Luciana, Hoette, Susana, Jardim, Carlos, Souza, Rogerio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5938486/
https://www.ncbi.nlm.nih.gov/pubmed/29791520
http://dx.doi.org/10.6061/clinics/2018/e216
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author Gavilanes-Oleas, Francisca Alexandra
Alves, Jose Leonidas
Fernandes, Caio Julio Cesar
Prada, Luis Felipe Lopes
Salibe, William
Terra, Mario
Morinaga, Luciana
Hoette, Susana
Jardim, Carlos
Souza, Rogerio
author_facet Gavilanes-Oleas, Francisca Alexandra
Alves, Jose Leonidas
Fernandes, Caio Julio Cesar
Prada, Luis Felipe Lopes
Salibe, William
Terra, Mario
Morinaga, Luciana
Hoette, Susana
Jardim, Carlos
Souza, Rogerio
author_sort Gavilanes-Oleas, Francisca Alexandra
collection PubMed
description OBJECTIVES: Chronic thromboembolic pulmonary hypertension is one of the most prevalent forms of pulmonary hypertension and is a major complication of acute pulmonary embolism. One mainstay of chronic thromboembolic pulmonary hypertension treatment is lifelong anticoagulation. The recent advent of direct oral anticoagulants for acute pulmonary embolism treatment has provided a viable and effective alternative for treating this condition. However, little is known about the efficacy of this new class of drugs for treating chronic thromboembolic pulmonary hypertension. We aimed to evaluate the safety and efficacy of direct oral anticoagulants in the treatment of chronic thromboembolic pulmonary hypertension. METHODS: A cohort of chronic thromboembolic pulmonary hypertension patients who initiated treatment with direct oral anticoagulants between June 2015 and November 2016 were enrolled in this study. RESULTS: Sixteen patients used rivaroxaban, three used dabigatran and one used apixaban for a mean follow-up of 20.9 months. The mean age was 51 years, and eighteen patients were classified as functional class II/III. Eight patients underwent a pulmonary endarterectomy and exhibited clinical, hemodynamic and functional improvement and currently continue to use direct oral anticoagulants. No episode of venous thromboembolism recurrence was identified during the follow-up period, but there was one episode of major bleeding after a traumatic fall. CONCLUSIONS: Although direct oral anticoagulants appear to be a safe and effective alternative for treating chronic thromboembolic pulmonary hypertension, larger studies are needed to support their routine use.
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spelling pubmed-59384862018-05-08 Use of direct oral anticoagulants for chronic thromboembolic pulmonary hypertension Gavilanes-Oleas, Francisca Alexandra Alves, Jose Leonidas Fernandes, Caio Julio Cesar Prada, Luis Felipe Lopes Salibe, William Terra, Mario Morinaga, Luciana Hoette, Susana Jardim, Carlos Souza, Rogerio Clinics (Sao Paulo) Original Article OBJECTIVES: Chronic thromboembolic pulmonary hypertension is one of the most prevalent forms of pulmonary hypertension and is a major complication of acute pulmonary embolism. One mainstay of chronic thromboembolic pulmonary hypertension treatment is lifelong anticoagulation. The recent advent of direct oral anticoagulants for acute pulmonary embolism treatment has provided a viable and effective alternative for treating this condition. However, little is known about the efficacy of this new class of drugs for treating chronic thromboembolic pulmonary hypertension. We aimed to evaluate the safety and efficacy of direct oral anticoagulants in the treatment of chronic thromboembolic pulmonary hypertension. METHODS: A cohort of chronic thromboembolic pulmonary hypertension patients who initiated treatment with direct oral anticoagulants between June 2015 and November 2016 were enrolled in this study. RESULTS: Sixteen patients used rivaroxaban, three used dabigatran and one used apixaban for a mean follow-up of 20.9 months. The mean age was 51 years, and eighteen patients were classified as functional class II/III. Eight patients underwent a pulmonary endarterectomy and exhibited clinical, hemodynamic and functional improvement and currently continue to use direct oral anticoagulants. No episode of venous thromboembolism recurrence was identified during the follow-up period, but there was one episode of major bleeding after a traumatic fall. CONCLUSIONS: Although direct oral anticoagulants appear to be a safe and effective alternative for treating chronic thromboembolic pulmonary hypertension, larger studies are needed to support their routine use. Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo 2018-05-08 2018 /pmc/articles/PMC5938486/ /pubmed/29791520 http://dx.doi.org/10.6061/clinics/2018/e216 Text en Copyright © 2018 CLINICS http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.
spellingShingle Original Article
Gavilanes-Oleas, Francisca Alexandra
Alves, Jose Leonidas
Fernandes, Caio Julio Cesar
Prada, Luis Felipe Lopes
Salibe, William
Terra, Mario
Morinaga, Luciana
Hoette, Susana
Jardim, Carlos
Souza, Rogerio
Use of direct oral anticoagulants for chronic thromboembolic pulmonary hypertension
title Use of direct oral anticoagulants for chronic thromboembolic pulmonary hypertension
title_full Use of direct oral anticoagulants for chronic thromboembolic pulmonary hypertension
title_fullStr Use of direct oral anticoagulants for chronic thromboembolic pulmonary hypertension
title_full_unstemmed Use of direct oral anticoagulants for chronic thromboembolic pulmonary hypertension
title_short Use of direct oral anticoagulants for chronic thromboembolic pulmonary hypertension
title_sort use of direct oral anticoagulants for chronic thromboembolic pulmonary hypertension
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5938486/
https://www.ncbi.nlm.nih.gov/pubmed/29791520
http://dx.doi.org/10.6061/clinics/2018/e216
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