Journal article

Should patients with systemic sclerosis-related pulmonary arterial hypertension be anticoagulated?

M Nikpour, W Stevens, SM Proudman, R Buchbinder, D Prior, J Zochling, T Williams, E Gabbay, H Nandurkar

INTERNAL MEDICINE JOURNAL | WILEY | Published : 2013

Abstract

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-desig..

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