Evidence map›Paper›PMID 28643420›Full record

Observational studyCardiovascular therapeutics2017

Impact on survival of warfarin in patients with pulmonary arterial hypertension receiving subcutaneous treprostinil.

Mona Ascha, Xuan Zhou, Youlan Rao, Omar A Minai, Adriano R Tonelli

Open access · bronzeAbstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Cardiovascular therapeutics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Perioperative approach to precapillary pulmonary hypertension in non-cardiac non-obstetric surgery.European respiratory review : an official journal of the European Respiratory Society · 2021
    Review
  3. Review
  4. Review
  5. Article
  6. Article
  7. Treatment of pulmonary hypertension after seven world symposia.Therapeutic advances in respiratory disease
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Mona AschaCase Western Reserve University School of Medicine, Cleveland, OH, USA.ORCID http://orcid.org/0000-0003-1807-4465
Xuan ZhouUnited Therapeutics Corporation, Research Triangle Park, NC, USA.
Youlan RaoUnited Therapeutics Corporation, Research Triangle Park, NC, USA.
Omar A MinaiPulmonary and Critical Care, Southside Regional Medical Center, Petersburg, VA, USA.
Adriano R TonelliDepartment of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA.
Triangle · USCleveland Clinic · USRegional Medical Center · USUniversity School · US

Funding

Clinical and Translational Science Collaborative of ClevelandUL1TR000439 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI KONSTAN, MICHAEL W. · 2012 to 2016
$50.0M
Clinical and Translational Science Collaborative of ClevelandKL2TR000440 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI KONSTAN, MICHAEL W. · 2012 to 2016
$11.1M
Extrapulmonary Microvascular Dysfunction in Pulmonary Arterial HypertensionR01HL130307 · NHLBI · CLEVELAND CLINIC LERNER COM-CWRU · PI TONELLI, ADRIANO · 2016 to 2020
$2.0M
NCATS NIH HHS KL2 TR000440NCATS NIH HHS UL1 TR000439NHLBI NIH HHS R01 HL130307
6 · The paper itself

Abstract

introductionAnticoagulation is a common treatment modality in patients with pulmonary arterial hypertension (PAH). Further studies are needed to appropriately assess the risk/benefit ratio of anticoagulation, particularly in PAH patients receiving PAH-specific therapies.

aimsWe use observational long-term data on PAH patients treated with subcutaneous (SQ) treprostinil from a large open-label study. Patients were followed for up to 4 years. The use of warfarin and bleeding events were recorded.

resultsAt total of 860 patients (age [mean±SD] 46±15 years, 76% female, 83% Caucasian, 49% idiopathic PAH, and 76% New York Heart Association [NYHA] functional class III) were included. All patients received SQ treprostinil (15% also other pulmonary hypertension [PH]-therapies) and 590 (69%) received warfarin during the study. The proportions of women, African American, and idiopathic pulmonary hypertension (IPAH) patients were higher in the group receiving warfarin. A higher proportion of patients with congenital heart disease and portopulmonary hypertension did not receive warfarin. There were no differences in unadjusted long-term survival between PAH patients receiving warfarin or not (log-rank test, P value=.69), even when only considering idiopathic PAH (P=.32). In addition, no difference was found in adjusted long-term survival both in PAH (P=.84) and idiopathic PAH patients (P=.44) based on the use of warfarin. Furthermore, no survival difference based on the use of warfarin were noted between propensity score-matched PAH patients (P=.37).

conclusionsLong-term anticoagulation with warfarin was not associated with any significant effect on survival in PAH or idiopathic PAH patients treated with SQ treprostinil.

Indexed as

AdultAnticoagulantsAntihypertensive AgentsChi-Square DistributionEpoprostenolFamilial Primary Pulmonary HypertensionFemaleHemorrhageHumansInfusions, SubcutaneousKaplan-Meier EstimateMaleMiddle AgedPropensity ScoreProportional Hazards ModelsRisk AssessmentAnticoagulantsAntihypertensive AgentsEpoprostenoltreprostinilWarfarinAnticoagulationPulmonary arterial hypertensionSurvivalTreprostinilWarfarin

Identifiers

PMID28643420
PMCPMC5600501
OpenAlexW2645674338

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.