Does anticoagulation in Eisenmenger syndrome impact long-term survival?

Area of Science:

• Cardiology
• Pulmonary Hypertension
• Hematology

Background:

• Eisenmenger syndrome presents a complex clinical challenge with debated treatment strategies.
• The role of anticoagulation in preventing adverse events in Eisenmenger syndrome remains unstudied.
• Potential benefits of anticoagulation are counterbalanced by risks of hemoptysis and thrombosis.

Purpose of the Study:

• To investigate the impact of anticoagulation on long-term survival in patients with Eisenmenger syndrome.
• To compare survival rates between anticoagulated and non-anticoagulated patients with Eisenmenger physiology.
• To identify prognostic factors associated with mortality in Eisenmenger syndrome.

Main Methods:

• Retrospective cohort study including 144 patients with Eisenmenger physiology.
• Comparison of survival between 48 anticoagulated (AC) and 44 non-anticoagulated (non-AC) patients.
• Analysis using Cox and Kaplan-Meier methods to assess survival and prognostic factors.

Main Results:

• No significant difference in survival was observed between the AC and non-AC groups.
• Mortality was associated with advanced New York Heart Association class (3-4), right heart failure, and low mean corpuscular volume.
• Bleeding complications occurred in 16% of AC patients, with two fatalities.

Conclusions:

• Anticoagulation demonstrated no impact on long-term survival in this cohort of Eisenmenger syndrome patients.
• The findings suggest that anticoagulation may not be beneficial for survival in this condition.
• Further research is warranted to definitively establish the role of anticoagulation in Eisenmenger syndrome management.