Use of direct oral anticoagulants for chronic thromboembolic pulmonary hypertension
Autor(a) principal: | |
---|---|
Data de Publicação: | 2018 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/146272 |
Resumo: | 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. |
id |
USP-19_39026e1d110874f5de7eb0e869ed1619 |
---|---|
oai_identifier_str |
oai:revistas.usp.br:article/146272 |
network_acronym_str |
USP-19 |
network_name_str |
Clinics |
repository_id_str |
|
spelling |
Use of direct oral anticoagulants for chronic thromboembolic pulmonary hypertensionPulmonary ThrombosisPulmonary HypertensionDirect Oral AnticoagulantsOBJECTIVES: 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, Faculdade de Medicina, Universidade de São Paulo2018-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/14627210.6061/clinics/2018/e216Clinics; Vol. 73 (2018); e216Clinics; v. 73 (2018); e216Clinics; Vol. 73 (2018); e2161980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/146272/139961Copyright (c) 2018 Clinicsinfo:eu-repo/semantics/openAccessGavilanes-Oleas, Francisca AlexandraAlves Jr, Jose LeonidasFernandes, Caio Julio CesarPrada, Luis Felipe LopesSalibe Filho, WilliamTerra Filho, MarioMorinaga, LucianaHoette, SusanaJardim, CarlosSouza, Rogerio2019-05-14T11:48:50Zoai:revistas.usp.br:article/146272Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2019-05-14T11:48:50Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Use of direct oral anticoagulants for chronic thromboembolic pulmonary hypertension |
title |
Use of direct oral anticoagulants for chronic thromboembolic pulmonary hypertension |
spellingShingle |
Use of direct oral anticoagulants for chronic thromboembolic pulmonary hypertension Gavilanes-Oleas, Francisca Alexandra Pulmonary Thrombosis Pulmonary Hypertension Direct Oral Anticoagulants |
title_short |
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_sort |
Use of direct oral anticoagulants for chronic thromboembolic pulmonary hypertension |
author |
Gavilanes-Oleas, Francisca Alexandra |
author_facet |
Gavilanes-Oleas, Francisca Alexandra Alves Jr, Jose Leonidas Fernandes, Caio Julio Cesar Prada, Luis Felipe Lopes Salibe Filho, William Terra Filho, Mario Morinaga, Luciana Hoette, Susana Jardim, Carlos Souza, Rogerio |
author_role |
author |
author2 |
Alves Jr, Jose Leonidas Fernandes, Caio Julio Cesar Prada, Luis Felipe Lopes Salibe Filho, William Terra Filho, Mario Morinaga, Luciana Hoette, Susana Jardim, Carlos Souza, Rogerio |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Gavilanes-Oleas, Francisca Alexandra Alves Jr, Jose Leonidas Fernandes, Caio Julio Cesar Prada, Luis Felipe Lopes Salibe Filho, William Terra Filho, Mario Morinaga, Luciana Hoette, Susana Jardim, Carlos Souza, Rogerio |
dc.subject.por.fl_str_mv |
Pulmonary Thrombosis Pulmonary Hypertension Direct Oral Anticoagulants |
topic |
Pulmonary Thrombosis Pulmonary Hypertension Direct Oral Anticoagulants |
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. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/146272 10.6061/clinics/2018/e216 |
url |
https://www.revistas.usp.br/clinics/article/view/146272 |
identifier_str_mv |
10.6061/clinics/2018/e216 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/146272/139961 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2018 Clinics info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2018 Clinics |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 73 (2018); e216 Clinics; v. 73 (2018); e216 Clinics; Vol. 73 (2018); e216 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222763687870464 |