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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
2018
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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. |
format | Online Article Text |
id | pubmed-5938486 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo |
record_format | MEDLINE/PubMed |
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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