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[Aminorex-induced, plexogenic pulmonary arteriopathy: 25 years later!]
H Frank1, H P Gurtner, M Kneussl
1Universitätsklinik für Innere Medizin II, Abteilung für Kardiologie, Wien, Osterreich.
Zeitschrift Fur Kardiologie
|September 1, 1993
Summary
Anticoagulant therapy improved survival and reduced pulmonary pressures in patients with aminorex-induced pulmonary hypertension. Early warfarin treatment led to better long-term outcomes and functional status.
Area of Science:
- Cardiology
- Pulmonary Hypertension
- Pharmacology
Context:
- Aminorex (menocil) intake between 1966-1968 led to plexogenic pulmonary hypertension.
- Retrospective study of 104 patients diagnosed with aminorex-induced pulmonary hypertension.
- Standard treatment included digitalis and diuretics; anticoagulation with warfarin was administered to 52% of patients.
Purpose:
- To investigate the impact of anticoagulant therapy on the long-term prognosis of patients with aminorex-induced plexogenic pulmonary hypertension.
- To assess the influence of warfarin treatment on survival rates, pulmonary pressures, and functional classification (NYHA).
Summary:
- Patients treated with anticoagulant medication (warfarin) demonstrated significantly longer mean survival times (8.3 years) compared to non-anticoagulated patients (6.1 years).
- Early initiation of anticoagulant therapy (within 1 year of symptom onset) resulted in a mean survival of 10.9 years.
- A decrease in pulmonary pressures was observed in 57% of patients undergoing repeat right-heart catheterization, with two-thirds of these patients receiving anticoagulant therapy.
Impact:
- Anticoagulant therapy, particularly warfarin, shows a positive influence on survival and clinical outcomes in patients with a history of anorectic drug intake.
- Improved NYHA functional classification was noted in 44.8% of patients treated with warfarin, compared to 22.2% of those not receiving anticoagulation.
- Findings suggest that anticoagulant therapy is a crucial component in managing aminorex-induced pulmonary hypertension, improving patient prognosis.