title: Should patients with systemic sclerosis-related pulmonary arterial hypertension be anticoagulated?
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-designed randomised controlled trial.
authors.affiliation: Department of Medicine, St Vincent's Academic Centre, The University of Melbourne, Melbourne, Victoria, Australia. mnikpour@medstv.unimelb.edu.au
authors.forename: M
authors.initials: M
authors.lastname: Nikpour
authors.forename: W
authors.initials: W
authors.lastname: Stevens
authors.forename: S M
authors.initials: SM
authors.lastname: Proudman
authors.forename: R
authors.initials: R
authors.lastname: Buchbinder
authors.forename: D
authors.initials: D
authors.lastname: Prior
authors.forename: J
authors.initials: J
authors.lastname: Zochling
authors.forename: T
authors.initials: T
authors.lastname: Williams
authors.forename: E
authors.initials: E
authors.lastname: Gabbay
authors.forename: H
authors.initials: H
authors.lastname: Nandurkar
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D065627:Familial Primary Pulmonary Hypertension; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology*; D012595:Scleroderma, Systemic / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D000925:Anticoagulants