Olsson, Karen M., Delcroix, Marion, Ghofrani, H. Ardeschir, Tiede, Henning, Huscher, Doerte, Speich, Rudolf, Gruenig, Ekkehard, Staehler, Gerd, Rosenkranz, Stephan, Halank, Michael, Held, Matthias, Lange, Tobias J., Behr, Juergen, Klose, Hans, Claussen, Martin, Ewert, Ralf, Opitz, Christian F., Vizza, C. Dario, Scelsi, Laura ORCID: 0000-0001-9409-691X, Vonk-Noordegraaf, Anton, Kaemmerer, Harald, Gibbs, J. Simon R., Coghlan, Gerry, Pepke-Zaba, Joanna, Schulz, Uwe, Gorenflo, Matthias, Pittrow, David and Hoeper, Marius M. (2014). Anticoagulation and Survival in Pulmonary Arterial Hypertension Results From the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA). Circulation, 129 (1). S. 57 - 74. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1524-4539

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Abstract

Background-For almost 30 years, anticoagulation has been recommended for patients with idiopathic pulmonary arterial hypertension (IPAH). Supporting evidence, however, is limited, and it is unclear whether this recommendation is still justified in the modern management era and whether it should be extended to patients with other forms of pulmonary arterial hypertension (PAH). Methods and Results-We analyzed data from Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA), an ongoing European pulmonary hypertension registry. Survival rates of patients with IPAH and other forms of PAH were compared by the use of anticoagulation. The sample consisted of 1283 consecutively enrolled patients with newly diagnosed PAH. Anticoagulation was used in 66% of 800 patients with IPAH and in 43% of 483 patients with other forms of PAH. In patients with IPAH, there was a significantly better 3-year survival (P=0.006) in patients on anticoagulation compared with patients who never received anticoagulation, albeit the patients in the anticoagulation group had more severe disease at baseline. The survival difference at 3 years remained statistically significant (P=0.017) in a matched-pair analysis of n=336 IPAH patients. The beneficial effect of anticoagulation on survival of IPAH patients was confirmed by Cox multivariable regression analysis (hazard ratio, 0.79; 95% confidence interval, 0.66-0.94). In contrast, the use of anticoagulants was not associated with a survival benefit in patients with other forms of PAH. Conclusions-The present data suggest that the use of anticoagulation is associated with a survival benefit in patients with IPAH, supporting current treatment recommendations. The evidence remains inconclusive for other forms of PAH.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Olsson, Karen M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Delcroix, MarionUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ghofrani, H. ArdeschirUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tiede, HenningUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Huscher, DoerteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Speich, RudolfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gruenig, EkkehardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Staehler, GerdUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rosenkranz, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Halank, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Held, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lange, Tobias J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Behr, JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klose, HansUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Claussen, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ewert, RalfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Opitz, Christian F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vizza, C. DarioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scelsi, LauraUNSPECIFIEDorcid.org/0000-0001-9409-691XUNSPECIFIED
Vonk-Noordegraaf, AntonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kaemmerer, HaraldUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gibbs, J. Simon R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Coghlan, GerryUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pepke-Zaba, JoannaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schulz, UweUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gorenflo, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pittrow, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoeper, Marius M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-448700
DOI: 10.1161/CIRCULATIONAHA.113.004526
Journal or Publication Title: Circulation
Volume: 129
Number: 1
Page Range: S. 57 - 74
Date: 2014
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 1524-4539
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
INCIDENTMultiple languages
Cardiac & Cardiovascular Systems; Peripheral Vascular DiseaseMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/44870

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