Anticoagulation in Pulmonary Arterial Hypertension: Do We Know the Answer?. [Review] - 2021

Available online from MWHC library: 1995 - 2009, Available in print through MWHC library:1999-2007

The shear stress and hypoxia in the pulmonary artery in patients with pulmonary arterial hypertension(PAH) causes endothelial dysfunction, smooth muscle proliferation and activation of thrombotic pathways leading to in situ thrombosis. Targeting the thrombotic pathways is a proposed mechanism to slow disease progression and improve survival. Over the years, the survival in patients with PAH has improved due to multiple factors with the increased use of anticoagulation as one of them. Both European Respiratory Society/European Society of Cardiology and American College of Cardiology/American Heart Association guidelines make grade II recommendations for using anticoagulation in PAH. The guidelines are based on weak observational studies with high risk of bias which have only studied warfarin as the choice of anticoagulation. In this article, we review the pathophysiology, rationale and the current literature investigating the role of anticoagulation in PAH. Copyright (c) 2020 Elsevier Inc. All rights reserved.


English

0146-2806

10.1016/j.cpcardiol.2020.100738 [doi] S0146-2806(20)30214-0 [pii]


*Anticoagulants
*Hypertension, Pulmonary
*Pulmonary Arterial Hypertension
*Thrombosis
Anticoagulants/tu [Therapeutic Use]
Humans
Hypertension, Pulmonary/dt [Drug Therapy]
Pulmonary Arterial Hypertension/dt [Drug Therapy]
Pulmonary Artery
Randomized Controlled Trials as Topic
Thrombosis/dt [Drug Therapy]


MedStar Union Memorial Hospital


Medicine
MedStar Health Baltimore Residents


Journal Article
Review