AMINOREX-INDUCED PLEXOGENIC PULMONARY ART ERIOPATHY - 25 YEARS AFTER THE EPIDEMIC EVENT

The purpose of this study was to examine the influence of treatment on long-term prognosis of patients with aminorex-induced plexogenic pulm onary hypertension. The study included 104 patients (13 males, 91 fema les) with an aminorex (menocil) intake between 1966 and 1968. All pati ents were treated with digitalis and diuretics, 52% received an antico agulant medication with warfarin after pulmonary hypertension was diag nosed. During follow-up, a second right-heart catheterization was perf ormed in 37 patients with a mean interval of 5 years. The longest mean survival time, 8.3 years, was found in patients treated with anticoag ulant medication, compared to the 6.1 years found in the non-anticoagu lated aminorex patients. Also, in the 5- and 10-years survival rate, p atients with an anticoagulant therapy have shown better results (62.9 vs. 38% and 39 vs. 20%, respectively). Patients who received anticoagu lant therapy soon after the onset of symptoms showed a better mean sur vival (1 0.9 years) than those who commenced treatment more than 1 yea r thereafter (mean survival 5.9 years). In 57% of the patients, who ha d a second right-heart catheterization a decrease of pulmonary pressur es could be diagnosed. Two-thirds of these patients with pulmonary pre ssure decrease were under anticoagulant therapy. An improvement in the NYHA-classification was seen in 44.8% of the patients treated with wa rfarin, in comparison to 22.2% of those who did not receive anticoagul ant therapy. Although this study is retrospective, it shows a positive influence of anticoagulant therapy on survival in patients with a his tory of anorectic drug intake.