Type of anticoagulant therapy as a risk factor for the severity of chronic thromboembolic pulmonary hypertension

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Introduction: In the last five years, there has been a growing trend towards the use of direct oral anticoagulants (DOACs) as a long-term anticoagulant therapy in patients who have had pulmonary embolism (PE). Vitamin K antagonists (VKAs) still remain the first-line anticoagulant therapy. Aim: The aim of the study was to investigate the type of long-term anticoagulant therapy after PE as a risk factor for the severity of chronic thromboembolic pulmonary hypertension (CTEPH). Methods: Ordinal logistic regression was used to examine the effect of therapy on the severity of CTEPH. The severity of CTEPH was defined according to the values of parameters measured by right heart catheterization. Results: CTEPH was diagnosed in 21 patients over a two-year period. A higher proportion of patients had therapy with DOACs versus VKA, 71.4% vs. 28.6%. According to the mean pulmonary arterial pressure (mPAP) value, the largest number of patients had the severe form of the disease, followed by moderate and mild forms, 42.9% vs. 33.3% vs. 23.8% respectively. The choice of anticoagulants did not show any statistically significant effect on any of the parameters regarding the severity of CTEPH (Table 1). Conclusions: The type of anticoagulant therapy in patients with CTEPH is not associated with any hemodynamic parameters and does not affect the severity of the disease.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.