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Clinical Investigations: Pulmonary VasculatureThe Effect of Anticoagulant Therapy in Primary and Anorectic Drug-Induced Pulmonary Hypertension
Section snippets
Patients
One hundred seventy-three patients (29 men, 144 women) with primary or drug-induced pulmonary hypertension from the Vienna and Berne cardiac centers were studied retrospectively with regard to survival time, changes in pulmonary artery pressure, and quality of life as scored by the New York Heart Association (NYHA) classification. Secondary causes, such as pulmonary embolism, obstructive and restrictive lung disease, intracardial and extracardial shunt lesions, and cardiomyopathies were
Survival Time
General Remarks: We observed that patients with exogenous pulmonary hypertension, such as aminorex-induced plexogenic pulmonary arteriopathy, had a significant better survival time than patients with idiopathic or PPH, independent of any anticoagulant therapy (7.5±0.6 years vs 3.9±0.5 years; p≤0.001). For the entire patient population studied, regardless of whether pulmonary hypertension was exogenous or not, anticoagulation generally showed a significant influence in survival time (7.2±0.6
Discussion
Pulmonary hypertension is usually secondary to cardiac or pulmonary disease and only rarely is “primary, idiopathic” or “unexplained.”7 Aminorex fumarate, which became available as an anorectic drug in three European countries (Germany, Switzerland, Austria), caused an increase in the number of cases of unexplained pulmonary arterial hypertension between 1965 and 1969, also called plexogenic pulmonary arteriopathy.8
Treatment of primary or unexplained pulmonary hypertension remains among the
Acknowledgment
The authors thank Valentin Fuster, MD, and Charles Hales, MD, for their helpful review of this manuscript. We also thank Jo Anne Fordham for proofreading the manuscript and Michael Hiegetsberger, PhD, who produced the graphs for this article.
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