Antithrombotic therapy in patients with pulmonary arterial hypertension

Histology studies fnd organized thrombi in small pulmonary arteries in 57% patients with idiopathic pulmonary arterial hypertension (PAH). This evidence justifed a rationale for the widespread use of oral anticoagulants (OAK) in patients with PAH of various etiologies. In recent years, the concept of OAK therapy in PAH patients has changed due to the novel data from clinical retrospective and prospective studies involving patients with PAH of various etiologies who have received anticoagulants. The present review discusses possible risk factors for thrombosis and bleeding in patients with PAH, indications, effcacy, and safety of OAK therapy in diverse PAH etiologies.