The purpose of this study was to examine the influence of treatment on long-term prognosis of patients with
aminorex-induced plexogenic
pulmonary hypertension. The study included 104 patients (13 males, 91 females) with an
aminorex (
menocil) intake between 1966 and 1968. All patients were treated with digitalis and
diuretics, 52% received an
anticoagulant medication with
warfarin after
pulmonary hypertension was diagnosed. During follow-up, a second right-heart catheterization was performed in 37 patients with a mean interval of 5 years. The longest mean survival time, 8.3 years, was found in patients treated with
anticoagulant medication, compared to the 6.1 years found in the non-anticoagulated
aminorex patients. Also, in the 5- and 10-years survival rate, patients with an
anticoagulant therapy have shown better results (62.9 vs. 38% and 39 vs. 20%, respectively). Patients who received
anticoagulant therapy soon after the onset of symptoms showed a better mean survival (10.9 years) than those who commenced treatment more than 1 year thereafter (mean survival 5.9 years). In 57% of the patients who had a second right-heart catheterization a decrease of pulmonary pressures could be diagnosed. Two-thirds of these patients with pulmonary pressure decrease were under
anticoagulant therapy. An improvement in the NYHA-classification was seen in 44.8% of the patients treated with
warfarin, in comparison to 22.2% of those who did not receive
anticoagulant therapy. Although this study is retrospective, it shows a positive influence of
anticoagulant therapy on survival in patients with a history of
anorectic drug intake.