Allergic bronchopulmonary aspergillosis — SCE Respiratory MCQ

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HardRespiratory InfectionsAllergic bronchopulmonary aspergillosisSCE Respiratory

A patient with chronic thromboembolic pulmonary hypertension and triple-positive antiphospholipid syndrome has undergone successful pulmonary endarterectomy. Which long-term antithrombotic agent is preferred?

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Correct answer: E — Warfarin

Therapeutic anticoagulation is lifelong in chronic thromboembolic pulmonary hypertension, including after apparently successful pulmonary endarterectomy. When antiphospholipid syndrome is present, a vitamin K antagonist such as warfarin is recommended rather than a direct oral anticoagulant. Antiplatelet monotherapy does not provide adequate protection.

Reference: 2022 ESC and ERS pulmonary-hypertension guideline in the European Respiratory Journal (Published 2022): https://publications.ersnet.org/content/erj/61/1/2200879; ERS statement on chronic thromboembolic pulmonary hypertension (Published 2021): https://publications.ersnet.org/content/erj/57/6/2002828