کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5621830 1579193 2017 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Full Length ArticleAntithrombotic therapy after bioprosthetic aortic valve implantation: Warfarin versus aspirin, a randomized controlled trial
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Full Length ArticleAntithrombotic therapy after bioprosthetic aortic valve implantation: Warfarin versus aspirin, a randomized controlled trial
چکیده انگلیسی


- Largest randomized trial testing warfarin versus aspirin after bioprosthetic aortic valve
- No difference in thromboembolic events between warfarin and aspirin
- Warfarin therapy associated with significantly more bleeding
- Difficult to maintain patients in therapeutic INR interval

BackgroundThe optimal medical strategy for prevention of thromboembolic events after surgical bioprosthetic aortic valve replacement (BAVR) is still debated. The objective of this study was to compare warfarin therapy (target INR of 2.0 to 3.0) with aspirin 150 mg daily as antithrombotic therapy for the first three months after BAVR with or without concomitant coronary artery bypass grafting (CABG). The aim was to evaluate thromboembolic complications, major bleeding complications and death.Materials and methodsProspective, single-centre, open-label, randomized controlled trial. 370 patients were enrolled, 328 were available for data analysis.ResultsAt baseline the warfarin and aspirin groups were comparable. Thromboembolic events were comparable between groups 11 (6.6%) vs. 12 (7.5%), p = 0.83. Major bleeding events occurred numerically more often in warfarin patients 9 (5.4%) vs. 3 (1.9%), p = 0.14. Warfarin was in multivariate analysis significantly associated with major bleeding OR 5.18 (CI 1.06-25.43), p = 0.043. 90-day mortality was comparable between groups 8 (4.7%) vs. 6 (3.7%), p = 0.79.ConclusionsOur results suggest that aspirin might be equally effective as warfarin in preventing thromboembolic events after BAVR, but with less major bleedings. Although this is numerically the largest trial testing this hypothesis in a prospective randomized trial, further adequately powered studies are warranted.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Thrombosis Research - Volume 150, February 2017, Pages 104-110
نویسندگان
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