Laurent Bertoletti on Impact of Anticoagulants on Survival in Pulmonary Arterial Hypertension
Laurent Bertoletti, University Professor and Hospital Practitioner at Jean Monnet University, Saint-Etienne, shared on LinkedIn:
”Do anticoagulants really improve survival in pulmonary arterial hypertension (PAH)?
Our study shows that routine anticoagulation does not confer an overall survival benefit: analysis of 1,597 patients from the French PAH registry found no significant reduction in mortality (HR 0.997; 95% CI 0.84–1.18).
These results were consistents across PAH subgroups, and confirmed by an updated meta-analysis.
The discussion is open!
Why this study?
The use of anticoagulants in PAH remains controversial, with prior evidence limited to observational data and often contradictory.
- We examined the French PAH Registry, drawing on robust methodology and biostatistics expertise . Céline Chapelle with the help of Silvy Laporte and Edouard Ollier.
- We analyzed 1,597 incident patients diagnosed with PAH between 2009 and 2020, each with at least 3 years of follow-up. After propensity‑score matching, no survival benefit was found in any PAH subtype.
- We then performed a meta‑analysis of contemporary national registry studies. The results confirm no significant reduction in mortality with anticoagulants (HR 0.98; 95% CI 0.78–1.23), regardless of PAH subgroup.
Overall, anticoagulation does not provide a measurable survival benefit. In the absence of randomized trials and given the risk of bleeding, this strategy should be reserved for carefully selected patients.
These results do not apply to patients with validated indication for anticoagulant therapy, as AF or VTE
Jean Escal, David Montani, Athénaïs Boucly, Laurent Savale, Xavier Jais, Xavier Delavenne and the others co-authors, and all the PULMOTENSION network from RespiFil
Thanks to all the patients and research teams for their contributions, and to the JACC Journals editorial team”
Read the full article in JACC Journals.
Article: Association Between Anticoagulant Therapy and Survival in Pulmonary Arterial Hypertension: A Registry Report and Updated Meta-Analysis
Authors: Laurent Bertoletti,Jean Escal, Athénaïs Boucly, Ségolène Turquier, Mitja Jevnikar, Nicolas Lamblin, Souad Bezzeghoud, Celine Chapelle, Xavier Delavenne, Laurent Savale, Marc Humbert, David Montani, Olivier Sitbon, and Xavier Jais
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