Clinical outcomes between direct oral anticoagulants versus vitamin K antagonists in chronic thromboembolic pulmonary hypertension: A systematic review and meta-analysis

Salazar et al., 2024 | Curr Probl Cardiol | Meta Analysis

Citation

Salazar Adolfo Martinez, Panama Gabriel, ... Abela George S. Clinical outcomes between direct oral anticoagulants versus vitamin K antagonists in chronic thromboembolic pulmonary hypertension: A systematic review and meta-analysis. Curr Probl Cardiol. 2024-Mar;49(3):102377. doi:10.1016/j.cpcardiol.2024.102377

Abstract

Pulmonary hypertension (PH) is a known chronic condition that can lead to increased morbidity and mortality. Patients who develop PH due to thromboembolic disease are catalogued as chronic thromboembolic pulmonary hypertension (CTEPH). Anticoagulation remains a topic of interest in these patients. PUBMED, EMBASE and COCHRANE databases were searched by two investigators until December 2023. Information was analyzed for all-cause mortality, venous thromboembolism and major bleeding. We included a total of 10 studies in this meta-analysis. Our pooled analysis demonstrated that DOACs were non-inferior in all-cause mortality [OR 0.88, 95 % CI (0.48, 1.61)], venous thromboembolism [OR 1.00, 95 % CI (0.50, 1.98)] and major bleeding [OR 0.78, 95 % CI (0.43, 1.40)] when compared to VKAs. In conclusion, our meta-analysis supports the use of DOACs in patients with CTEPH. Further randomized trials are still needed to confirm our results in terms of safety and mortality.

Key Findings

Further randomized trials are still needed to confirm our results in terms of safety and mortality.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population cteph
Sample Size 10
Age Range See abstract
Condition hypertension

MeSH Terms

  • Humans
  • Hypertension, Pulmonary
  • Vitamin K
  • Pulmonary Embolism
  • Administration, Oral
  • Chronic Disease
  • Anticoagulants
  • Treatment Outcome
  • Factor Xa Inhibitors

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Meta-Analysis, Systematic Review, Journal Article
  • Vertical: vitamin-k

Provenance


Source extracted via PubMed E-utilities API on 2026-04-09