According to a story from Pulmonary Advisor, the results of a recent analysis led researchers to conclude that systemic anticoagulation therapy can be beneficial for patients with idiopathic pulmonary arterial hypertension (PAH). “Idiopathic” refers to disease without a clear cause. However, the researchers found that the benefit was not present in a model of the condition associated with connective tissue disease (CTD).
About Pulmonary Arterial Hypertension (PAH)
Pulmonary arterial hypertension is a condition in which the blood pressure in the arteries of the lungs is abnormally high. The cause of pulmonary arterial hypertension is often unknown in many cases. However, there are a variety of potential causes, such as certain heritable genetic mutations, exposure to certain toxins, and drug use (ex. methamphetamine). It can also appear as a symptom or complication in a number of other diseases, such as heart disease, connective tissue disease, and infection with HIV. The arteries in the lungs are often inflamed. Symptoms of this condition include rapid heartbeat, poor exercise tolerance, shortness of breath, fainting, leg swelling, fatigue, and chest pain. Treatment may include a number of medications and surgical operations, including lung transplant. A transplant can cure the condition, but it can cause many complications. Survival rate is often only about two or three years without treatment, but the latest drugs can prolong life by several years or more. Click here to learn more about pulmonary arterial hypertension.
About the Study
The benefit of systemic anticoagulation was defined by quality adjusted life years. The study used a Markov simulation decision analytic model, which compared the impacts of anticoagulation versus no anticoagulation in models of both idiopathic and CTD-associated pulmonary arterial hypertension as well as other variations in patient characteristics, such as gender and use of other medications. Anticoagulation therapy in the model was with vitamin K antagonists (VKAs).
The choice to use VKAs was favored in 97 to 98.3 percent of females with idiopathic disease and 75.7 to 79.5 percent of males. These patients saw a benefit of 0.43 to .51 quality adjusted life years. Meanwhile, avoiding VKAs was favorable in 95.5. to 99 percent of patients with CTD-associated disease. In fact, use of VKAs was found to be detrimental in these cases producing a loss of as much as 1.89 quality adjusted life years.
The authors concluded that VKAs can be useful for idiopathic disease, but are harmful for CTD-associated disease. However, future studies may find different results with other types of systemic anticoagulation therapy.
Check out the original study here in the journal Pulmonary Circulation.