Abstract:
:Pulmonary hypertension (PH) is often caused by left heart disease (LHD) such as heart failure (HF) or valvular heart disease. Historically, few randomized controlled trials have evaluated the off-label use of medications for treating pulmonary arterial hypertension (PAH) in patients with PH-LHD. However, multiple randomized controlled trials have been published over the last decade that investigated their use in patients with PH-LHD. In addition, recent updates in the classification and definitions of PH have led to an improved recognition of PH-LHD phenotypes, notably combined post-capillary and pre-capillary PH and isolated post-capillary PH. In this systematic review, we show that PAH medications should not be recommended in two distinct HF populations: patients with HF without definitive PH diagnosis and patients with isolated post-capillary PH due to HF. In addition, the use of bosentan or macitentan is not recommended in patients with combined post-capillary and pre-capillary PH due to HF, but sildenafil may be considered to improve pulmonary hemodynamics and exercise capacity in patients with combined post-capillary and pre-capillary PH due to HF. Riociguat 2 mg 3 times daily may also be considered to improve pulmonary hemodynamics in patients with combined post-capillary and pre-capillary PH due to heart failure with reduced ejection fraction but not heart failure with preserved ejection fraction. The postoperative use of sildenafil in the setting of PH after valvular heart disease intervention was evaluated. Limited clinical data and safety concern warrants caution with the postoperative use of sildenafil in patients with PH due to valvular heart disease. Despite recent advances in the understanding of PAH medications for patients with PH-LHD, uncertainty remains about their utility in distinct subgroups. Nonetheless, PAH pharmacotherapy should generally be avoided for most patients with PH-LHD.
journal_name
Pharmacotherapyjournal_title
Pharmacotherapyauthors
Kido K,Coons JCdoi
10.1002/phar.2314subject
Has Abstractpub_date
2019-09-01 00:00:00pages
929-945issue
9eissn
0277-0008issn
1875-9114journal_volume
39pub_type
杂志文章相关文献
PHARMACOTHERAPY文献大全abstract:BACKGROUND:It is known that γ-glutamyl hydrolase (GGH) is involved in the disposition of methotrexate (MTX), and GGH activity is regulated by DNA methylation in acute lymphoblastic leukemia (ALL) cells. The present study explores the methylation status of the GGH promoter in peripheral blood and its association with MT...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1002/phar.2430
更新日期:2020-07-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the pharmacokinetics and pharmacodynamics of fludarabine in patients with rheumatoid arthritis (RA). DESIGN:Open-label, staggered trial conducted in conjunction with a phase I-II clinical trial. SETTING:Government research hospital. PATIENTS:Twenty-six patients with refractory RA. INTERV...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章
doi:
更新日期:1998-11-01 00:00:00
abstract::The field of acid suppression has been advanced by therapeutics of increasing specificity for inhibiting gastric acid secretion. Particularly important are proton pump inhibitors (PPIs), which inhibit the activity of the gastric acid pump (H+,K(+)-adenosine triphosphatase), the final common step in gastric acid produc...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.23.13.68s.31931
更新日期:2003-10-01 00:00:00
abstract::Low-molecular-weight heparins (LMWHs) are safe and effective in the treatment of venous thromboembolic disease. Since they require less therapeutic monitoring than unfractionated heparin and may be administered to outpatients, it is possible to decrease overall health care costs of patients diagnosed with deep vein th...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:
更新日期:1998-11-01 00:00:00
abstract::Ongoing improvements in immunosuppression and posttransplantation care have dramatically improved patient and graft outcomes after transplantation. The frequency of graft loss due to acute rejection has declined considerably as a result of the availability of a variety of more potent immunosuppressive agents and proba...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.22.5.316.33198
更新日期:2002-03-01 00:00:00
abstract::The complexities of oral anticoagulation with warfarin have led to the search for more practical alternative agents. Novel direct factor IIa inhibitors and direct factor Xa inhibitors currently in development can be administered at a fixed dose and do not require routine coagulation monitoring and ongoing dosage adjus...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.31.12.1175
更新日期:2011-12-01 00:00:00
abstract::Limitations of traditional anticoagulants have led to the need for structured services to provide anticoagulation monitoring. Anticoagulation management services have historically filled this role. Novel antithrombotic agents currently in development have the potential to improve on the limitations of vitamin K antago...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.24.15.199s.43159
更新日期:2004-10-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the feasibility of therapeutic drug monitoring for adjusting low serum antimycobacterial concentrations in patients with both tuberculosis and advanced human immunodeficiency virus (HIV). DESIGN:Retrospective cohort study. DATA SOURCE:De-identified dataset from a tuberculosis clinic. PAT...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.29.5.503
更新日期:2009-05-01 00:00:00
abstract::Warfarin is considered a high-risk drug because of its narrow therapeutic window, variability in dose response, and multitude of drug and food interactions. Although travel advice is available for patients who are taking warfarin, it is geared toward patients who are traveling to developed countries and tends to be la...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1002/j.1875-9114.2012.01019.x
更新日期:2012-03-01 00:00:00
abstract::Females of childbearing age represent a large population of solid organ transplant recipients. With fertility commonly restored after transplantation, the possibility of pregnancy becomes a reality for many patients. Since the first published report of a successful pregnancy after solid organ transplantation in 1963, ...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/phar.1800
更新日期:2016-09-01 00:00:00
abstract::Genotype-guided warfarin dosing algorithms are a rational approach to optimize warfarin dosing and potentially reduce adverse drug events. Diverse populations, such as African Americans and Latinos, have greater variability in warfarin dose requirements and are at greater risk for experiencing warfarin-related adverse...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/phar.1982
更新日期:2017-09-01 00:00:00
abstract::Meta-analyses are key components of evidence-based decision making. The numbers of meta-analyses published in different areas of health care increased dramatically during the past 10 years. Many of them covered different pharmacologic interventions, making them useful resources to clinical pharmacists. Although a well...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.19.9.741.31541
更新日期:1999-06-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the extent of hospital-based clinical pharmacy services in 1992. DESIGN:National survey with trend comparison to 1989. SETTING:All 1597 United States acute care, general medical-surgical and pediatric hospitals with 50 or more licensed beds and one or more full-time pharmacists (43% of al...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract::Hepatic drug metabolism is altered in critically ill patients. The etiology and mechanisms of the alterations are not clearly understood and are difficult to address in clinical studies. For this reason, in vitro and animal models were developed to investigate the effects of critical illness on hepatic drug metabolism...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:
更新日期:1998-07-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the effect of Niaspan--a niacin preparation with both immediate- and extended-release characteristics--on lipid and glycemic control in patients with type 2 diabetes. DESIGN:Retrospective study SETTING:Private-practice endocrinology group. PATIENTS:Thirty-two patients (mean age 60 yrs; 7...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.21.20.1473.34481
更新日期:2001-12-01 00:00:00
abstract::Antithrombin deficiency is a hypercoagulable state that can increase the risk for thrombosis, especially in the presence of other procoagulant triggers. Unfractionated heparin and low-molecular-weight heparins may not provide effective anticoagulation since they require antithrombin for activity. Direct thrombin inhib...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.24.6.659.34745
更新日期:2004-05-01 00:00:00
abstract::In recent years, there have been many updates in hormonal emergency contraception. Levonorgestrel emergency contraception has been available for several years to prevent pregnancy when used within 72 hours after unprotected intercourse or contraceptive failure, and it was recently approved for nonprescription status f...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.31.9.887
更新日期:2011-09-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the effects of acetaminophen, naproxen, and acetylsalicylic acid on the pharmacokinetics of the centrally acting analgesic tapentadol in healthy subjects. DESIGN:Two randomized, open-label, crossover, drug-drug interaction studies. SETTING:Clinical research facilities in the United States ...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1592/phco.30.1.25
更新日期:2010-01-01 00:00:00
abstract::Buspirone is the first of a new class of anxioselective agents, the azaspirodecanediones. It achieves peak serum concentrations within one hour and has a serum half-life of 2 to 5 hours. Animal studies have suggested antianxiety activity and the absence of abuse potential. Buspirone is both a dopamine agonist and anta...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/j.1875-9114.1984.tb03385.x
更新日期:1984-11-01 00:00:00
abstract:PURPOSE:Neurocritically ill patients have clinically significant alterations in pharmacokinetic parameters of renally eliminated medications that may result in subtherapeutic plasma and cerebrospinal fluid antibiotic concentrations. METHODS:We conducted a prospective randomized open-label study of adult neurocriticall...
journal_title:Pharmacotherapy
pub_type: 杂志文章,随机对照试验
doi:10.1002/phar.2156
更新日期:2018-09-01 00:00:00
abstract::A prospective cohort study was conducted in 35 hospitals with oncology units to determine the incidence of symptomatic cardiotoxicity in patients receiving continuous infusions of 5-fluorouracil (5-FU), and to identify risk factors that could contribute to the development of 5-FU-associated cardiotoxicity. A sample of...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章,多中心研究
doi:
更新日期:1997-07-01 00:00:00
abstract::Agitation in the elderly, manifested by verbal and physical aggression, frequently results in increased morbidity and mortality for nursing home residents and reduced morale for the family and nursing home staff. It is also responsible for increased costs associated with caring for these residents. Pharmacologic inter...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:
更新日期:1998-05-01 00:00:00
abstract::The systemic polymyxins, colistin and polymyxin B, are increasingly used for multidrug-resistant bacterial infections and have a long history of dose-limiting toxicity. This review summarizes the most recent available information about the mechanisms, incidence, risk factors, and minimization strategies for polymyxin ...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/phar.1493
更新日期:2015-01-01 00:00:00
abstract:STUDY OBJECTIVES:To determine the frequency and type of complementary and alternative medicine (CAM) use among healthy volunteers participating in research, and to investigate the potential for interactions between commonly used CAM modalities and various drugs. DESIGN:Prospective evaluation. SETTING:University gener...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.26.12.1794
更新日期:2006-12-01 00:00:00
abstract::We attempted to determine if an association exists between vancomycin serum concentrations resulting from traditional dosing regimens, and efficacy and toxicity outcomes. We reviewed the medical charts of 273 consecutive patients prescribed 273 courses of vancomycin therapy for documented, gram-positive bacteremia. Of...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract::For many years, a regimen of fluorouracil and cisplatin has been the standard of care for the treatment of patients with metastatic gastric cancer. More recently, triplet regimens that incorporate fluorouracil and cisplatin with epirubicin (ECF) or docetaxel are being used in the management of patients with metastatic...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.29.3.318
更新日期:2009-03-01 00:00:00
abstract::Oral anticoagulation with warfarin requires routine monitoring of prothrombin time, expressed as the international normalized ratio (INR). Patient self-testing for INR is common in Europe but not in the United States. In order to determine the frequency of INR self-testing among patients whose anticoagulant therapy is...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.25.2.265.56949
更新日期:2005-02-01 00:00:00
abstract::Infections in the cerebrospinal fluid (CSF) occur in an area of impaired host defenses; therefore, bactericidal antibiotics that reach adequate concentrations in the CSF are necessary for treatment. Measurements of antibiotic penetration into the CSF include CSF inhibitory and bactericidal titers, the absolute antibio...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the ability of seven widely known herbal references and electronic databases to answer questions about herbal products asked at drug information centers. DESIGN:Cross-sectional study. SETTING:Five academic and institutional drug information centers. METHODS:Fifty-seven herbal-related ques...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.22.17.1611.34126
更新日期:2002-12-01 00:00:00
abstract::Albuterol is a 50:50 mixture of R-albuterol, the active enantiomer, and S-albuterol, which appears to be inactive in humans. The Food and Drug Administration recently approved levalbuterol, the pure R-isomer, as a preservative-free nebulizer solution. Published studies indicate that it is neither safer nor more effect...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.20.3.123.34776
更新日期:2000-02-01 00:00:00