Porres-Aguilar Mateo, Hoeper Marius M, Rivera-Lebron Belinda N, Heresi Gustavo A, Mukherjee Debabrata, Tapson Victor F
Division of Hospital Medicine, Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA.
Division of Hospital Medicine, Department of Medicine, Sierra Providence Healthcare and Hospitals, El Paso, TX, USA.
J Thromb Thrombolysis. 2021 Oct;52(3):791-796. doi: 10.1007/s11239-021-02445-z. Epub 2021 Apr 9.
Chronic thromboembolic pulmonary hypertension (CTEPH) represents the later stage consequence of at least one or more unresolved episodes of acute pulmonary embolism; thus, indefinite anticoagulation is strongly recommended by current practice guidelines. Historically, vitamin K antagonists have been widely used in these patients. However, recent data indicate a shift toward direct oral anticoagulants (DOACs), despite lack of data on the safety and efficacy in this patient population. Herein, we briefly discuss the current rationale for oral anticoagulation use in CTEPH, addressing important issues and controversies involved with the use of DOACs, opening a strategy for further clinical research in the field of oral anticoagulation.
慢性血栓栓塞性肺动脉高压（CTEPH）是至少一次或多次未解决的急性肺栓塞发作的后期后果；因此，目前的实践指南强烈建议长期抗凝治疗。从历史上看，维生素K拮抗剂已在这些患者中广泛使用。然而，最近的数据表明正在转向使用直接口服抗凝剂（DOACs），尽管缺乏关于该患者群体安全性和有效性的数据。在此，我们简要讨论目前在CTEPH中使用口服抗凝剂治疗的基本原理，探讨使用DOACs所涉及的重要问题和争议，为口服抗凝领域的进一步临床研究开辟策略。
