Should patients with systemic sclerosis-related pulmonary arterial hypertension be anticoagulated?
Date
2013
Authors
Nikpour, M.
Stevens, W.
Proudman, S.
Buchbinder, R.
Prior, D.
Zochling, J.
Williams, T.
Gabbay, E.
Nandurkar, H.
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Journal article
Citation
Internal Medicine Journal, 2013; 43(5):599-603
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M. Nikpour, W. Stevens, S. M. Proudman, R. Buchbinder, D. Prior, J. Zochling, T. Williams, E. Gabbay and H. Nandurkar
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Abstract
Pulmonary arterial hypertension (PAH) is a major cause of mortality in scleroderma and despite ‘advanced’ therapies confers a median survival of less than 5 years. Anticoagulation in systemic sclerosis-related PAH (SSc-PAH) is currently one of the most contentious issues in the management of patients with connective tissue disease. While some studies have shown a survival benefit with warfarin therapy in this disease, others have not. Accordingly, a state of clinical equipoise exists in relation to anticoagulation in SSc-PAH. With an over fivefold reduction in mortality demonstrated in some observational studies, the issue of anticoagulation in SSc-PAH demands resolution through a well-designed randomised controlled trial.
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© 2013 The Authors