Direct oral anticoagulants in chronic thromboembolic pulmonary hypertension

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.

Automated summary

Patients with chronic thromboembolic pulmonary hypertension (CTEPH) are recommended indefinite anticoagulation therapy, with a recent shift towards direct oral anticoagulants (DOACs) despite lacking safety and efficacy data in this population. Important issues and controversies surrounding the use of DOACs in CTEPH patients need further clinical research exploration.