Use of direct oral anticoagulants in chronic thromboembolic pulmonary hypertension: a systematic review

J Thromb Thrombolysis. 2022 Jan;53(1):51-57. doi: 10.1007/s11239-021-02501-8. Epub 2021 Jun 16.

Abstract

Direct oral anticoagulants (DOACs) are being increasingly used in patients with chronic thromboembolic hypertension (CTEPH), however, the data on their safety and efficacy are scarce and contradictory. We systematically searched MEDLINE and Google Scholar databases from January 2010 to January 2021 for studies of DOACs in CTEPH. Three observational studies, 2 abstracts and one case series met our inclusion criteria. While these studies reported similar or even less rates of major bleeding in patients receiving DOACs compared with vitamin K antagonists, there were concerns about the possibility of increased risk of venous thromboembolism recurrence with DOAC therapy. Further studies are warranted to better define the role of DOACs in CTEPH.

Keywords: CTEPH; Chronic thromboembolic pulmonary hypertension; DOAC; Direct oral anticoagulants; Vitamin K antagonists.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Administration, Oral
  • Anticoagulants / adverse effects
  • Hemorrhage / chemically induced
  • Humans
  • Hypertension, Pulmonary* / drug therapy
  • Venous Thromboembolism* / chemically induced
  • Venous Thromboembolism* / drug therapy
  • Vitamin K

Substances

  • Anticoagulants
  • Vitamin K