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Should patients with systemic sclerosis‐related pulmonary arterial hypertension be anticoagulated?
Author(s) -
Nikpour M.,
Stevens W.,
Proudman S. M.,
Buchbinder R.,
Prior D.,
Zochling J.,
Williams T.,
Gabbay E.,
Nandurkar H.
Publication year - 2013
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.12111
Subject(s) - medicine , cardiology , pulmonary hypertension , intensive care medicine
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.