Key result
Anticoagulation therapy with warfarin was supported as an effective intervention for survival in pulmonary arterial hypertension by 5 out of 7 observational studies comprising 488 patients.
Why the study?
Does anticoagulation therapy with warfarin improve survival in patients with pulmonary arterial hypertension?
Systematic Review (n=488)
Does anticoagulation therapy with warfarin improve survival in patients with pulmonary arterial hypertension?
Observational data suggest warfarin may improve survival in pulmonary arterial hypertension, but randomized controlled trials are needed to confirm this finding.
May support warfarin consideration in PAH but should not change practice; leaves open confirmation by RCTs.
Thrombotic arteriopathy has been implicated in the pathophysiology of pulmonary arterial hypertension (PAH). However, the role of anticoagulants in the treatment of PAH is uncertain. Through a qualitative systematic review of epidemiological studies, the effectiveness of anticoagulation therapy with warfarin on survival was evaluated in patients with PAH. MEDLINE (1966 to November 2005), EMBASE (1966 to November 2005), bibliographies of included studies and published reviews were searched without language restriction. Epidemiological studies evaluating the effectiveness of warfarin in PAH were included. Studies had to report mortality as an outcome. Seven observational studies evaluating the effectiveness of warfarin comprising 488 patients were identified. Five studies support the effectiveness of anticoagulation therapy, whereas two do not. Data from observational studies suggest that anticoagulation therapy may be an effective intervention in pulmonary arterial hypertension. However, given the methodological limitations and the small number of existing observational studies, a randomised controlled trial is needed in order to definitively address this important clinical issue.
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Johnson et al. (2006) conducted a systematic review in Pulmonary arterial hypertension (n=488). Anticoagulation therapy with warfarin was evaluated on Mortality. Anticoagulation therapy with warfarin was supported as an effective intervention for survival in pulmonary arterial hypertension by 5 out of 7 observational studies comprising 488 patients.
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