Anticoagulation therapy versus placebo for pulmonary hypertension

Where do we go from here? Reappraising the data on anticoagulation in pulmonary arterial hypertension

“…There is strong pathophysiologic rationale for this type of therapy, as numerous studies have identified in situ thrombosis and a pro-coagulant milieu in PAH (3)(4)(5)(6)(7)(8)(9). Unfortunately, a paucity of randomized controlled studies has left practicing clinicians relying on a handful of observational investigations to guide practice patterns (1,2,10,11). Prior to publication of the Registry to Evaluate Early and Long-term PAH Disease Management (REVEAL) registry anticoagulation report, there were 9 cohort studies [2 prospective (12,13) and 7 retrospective (6,(14)(15)(16)(17)(18)(19)] specifically addressing the question of anticoagulation in PAH.…”