Anticoagulation in Patients with Mechanical Heart Valves: Less Is More?

Publication History

Received: 28 March 2024

Accepted: 29 March 2024

Article published online:
26 April 2024

• References

• 1 Iung B, Vahanian A. Epidemiology of valvular heart disease in the adult. Nat Rev Cardiol 2011; 8 (03) 162-172
• 2 Eikelboom JW, Connolly SJ, Brueckmann M. et al; RE-ALIGN Investigators. Dabigatran versus warfarin in patients with mechanical heart valves. N Engl J Med 2013; 369 (13) 1206-1214
• 3 Wang TY, Svensson LG, Wen J. et al. Apixaban or warfarin in patients with an On-X mechanical aortic valve. NEJM Evid 2023; 2 (07) EVIDoa2300067
• 4 Watkins DA, Johnson CO, Colquhoun SM. et al. Global, regional, and national burden of rheumatic heart disease, 1990-2015. N Engl J Med 2017; 377 (08) 713-722
• 5 Johansson I, Benz AP, Kovalova T. et al. Outcomes of patients with a mechanical heart valve and poor anticoagulation control on warfarin. Thromb Haemost 2024; 124 (07) 613-624
• 6 Labaf A, Svensson PJ, Renlund H, Jeppsson A, Själander A. Incidence and risk factors for thromboembolism and major bleeding in patients with mechanical valve prosthesis: a nationwide population-based study. Am Heart J 2016; 181: 1-9
• 7 Poli D, Antonucci E, Pengo V. et al; Italian Federation of Anticoagulation Clinics. Mechanical prosthetic heart valves: quality of anticoagulation and thromboembolic risk. The observational multicenter PLECTRUM study. Int J Cardiol 2018; 267: 68-73
• 8 Erba N, Tosetto A, Langer M. et al. Oral anticoagulant management of patients with mechanical heart valves at the Salam Centre of Khartoum: observations on quality of anticoagulation and thrombotic risk. Thromb Res 2022; 219: 155-161
• 9 Oake N, Fergusson DA, Forster AJ, van Walraven C. Frequency of adverse events in patients with poor anticoagulation: a meta-analysis. CMAJ 2007; 176 (11) 1589-1594
• 10 Poller L, Keown M, Ibrahim S. et al. An international multicenter randomized study of computer-assisted oral anticoagulant dosage vs. medical staff dosage. J Thromb Haemost 2008; 6 (06) 935-943
• 11 Poli D, Antonucci E, Grifoni E, Abbate R, Gensini GF, Prisco D. Bleeding risk during oral anticoagulation in atrial fibrillation patients older than 80 years. J Am Coll Cardiol 2009; 54 (11) 999-1002
• 12 Pastori D, Lip GYH, Poli D. et al; Italian Federation of Anticoagulation Clinics (FCSA). Determinants of low-quality warfarin anticoagulation in patients with mechanical prosthetic heart valves. The nationwide PLECTRUM study. Br J Haematol 2020; 190 (04) 588-593
• 13 Stein PD, Alpert JS, Dalen JE, Horstkotte D, Turpie AG. Antithrombotic therapy in patients with mechanical and biological prosthetic heart valves. Chest 1998; 114 (5, Suppl): 602S-610S
• 14 Acar J, Iung B, Boissel JP. et al. AREVA: multicenter randomized comparison of low-dose versus standard-dose anticoagulation in patients with mechanical prosthetic heart valves. Circulation 1996; 94 (09) 2107-2112
• 15 Otto CM, Nishimura RA, Bonow RO. et al; Writing Committee Members. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol 2021; 77 (04) 450-500
• 16 Vahanian A, Beyersdorf F, Praz F. et al; ESC/EACTS Scientific Document Group. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur J Cardiothorac Surg 2021; 60 (04) 727-800
• 17 Tosetto A, Manotti C, Marongiu F. and Italian Federation of Anticoagulation Clinics (FCSA) clinical quality study group. Center-related determinants of VKA anticoagulation quality: prospective a. multicenter evaluation. PLoS One 2015; 10 (12) e0144314