Antiplatelet and anticoagulation for patients with prosthetic heart valves

Left Atrial Appendage Closure in Patients With a Mechanical Mitral Valve Prosthesis: A Multicentre Italian Pilot Study

“…LAAC effectiveness in this setting has been confirmed by a recent trial that compared the long-term benefits of LAAC concomitant to cardiac surgery [21]. Enhancement of medical therapy in such scenarios lacks of comparative trials and the decision to improve antithrombotic therapy should be weighted considering several factors such as the bleeding risk [22]. In our study, median HAS-BLED score of the enrolled population was 3, justifying an alternative therapeutic choice.…”

Left Atrial Appendage Closure in Patients With a Mechanical Mitral Valve Prosthesis: A Multicentre Italian Pilot Study

“…LAAC effectiveness in this setting has been confirmed by a recent trial that compared the long-term benefits of LAAC concomitant to cardiac surgery [21]. Enhancement of medical therapy in such scenarios lacks of comparative trials and the decision to improve antithrombotic therapy should be weighted considering several factors such as the bleeding risk [22]. In our study, median HAS-BLED score of the enrolled population was 3, justifying an alternative therapeutic choice.…”

Review of anticoagulation options for mechanical valve prosthesis

“…Several groups have demonstrated similar effectiveness with reduced OAC therapy (compared with historically target INR of 3.0-4.5 in patients with bileaflet St. Jude Medical [St. Jude Medical, Inc., Saint Paul, MN, USA]) mechanical valves, mostly in the aortic position [21,27]. These results along with previously performed meta-analyses [16,20,26] have led to the universal recommendation of targeting INR between 2.0 and 2.5 for the aortic position and 3.0-3.5 for the mitral position [12,13]. A recent randomized clinical trial by Dong and colleagues evaluated…”

Anticoagulation for the Prevention of Arterial Thrombosis in Ambulatory Cancer Patients

“…There are several potential reasons for this null finding; first, anticoagulants alone have not been shown to be superior to antiplatelet agents for ATE prevention outside of atrial tachyarrhythmia, mechanical heart valves, and antiphospholipid antibody syndrome. 45 , 46 , 47 , 48 , 49 , 50 For example, a clinical trial involving 7,213 patients did not demonstrate a reduction in stroke recurrence among patients randomized to rivaroxaban 15 mg daily compared with aspirin after an embolic stroke of an undetermined source (5.1% vs 4.8%; HR: 1.07; P = 0.52), 48 with similar findings in the subgroup analysis of cancer patients. 47 Another clinical trial of over 27,000 patients with stable cardiovascular disease showed a reduction in cardiovascular death, stroke, or myocardial infarction with a combination of rivaroxaban 2.5 mg twice daily and aspirin compared with aspirin alone.…”

Left Atrial Appendage Closure in Patients With a Mechanical Mitral Valve Prosthesis: A Multicentre Italian Pilot Study

“…LAAC effectiveness in this setting has been confirmed by a recent trial that compared the long-term benefits of LAAC concomitant to cardiac surgery [21]. Enhancement of medical therapy in such scenarios lacks of comparative trials and the decision to improve antithrombotic therapy should be weighted considering several factors such as the bleeding risk [22]. In our study, median HAS-BLED score of the enrolled population was 3, justifying an alternative therapeutic choice.…”

Review of anticoagulation options for mechanical valve prosthesis

“…Several groups have demonstrated similar effectiveness with reduced OAC therapy (compared with historically target INR of 3.0-4.5 in patients with bileaflet St. Jude Medical [St. Jude Medical, Inc., Saint Paul, MN, USA]) mechanical valves, mostly in the aortic position [21,27]. These results along with previously performed meta-analyses [16,20,26] have led to the universal recommendation of targeting INR between 2.0 and 2.5 for the aortic position and 3.0-3.5 for the mitral position [12,13]. A recent randomized clinical trial by Dong and colleagues evaluated…”

Anticoagulation for the Prevention of Arterial Thrombosis in Ambulatory Cancer Patients

“…There are several potential reasons for this null finding; first, anticoagulants alone have not been shown to be superior to antiplatelet agents for ATE prevention outside of atrial tachyarrhythmia, mechanical heart valves, and antiphospholipid antibody syndrome. 45 , 46 , 47 , 48 , 49 , 50 For example, a clinical trial involving 7,213 patients did not demonstrate a reduction in stroke recurrence among patients randomized to rivaroxaban 15 mg daily compared with aspirin after an embolic stroke of an undetermined source (5.1% vs 4.8%; HR: 1.07; P = 0.52), 48 with similar findings in the subgroup analysis of cancer patients. 47 Another clinical trial of over 27,000 patients with stable cardiovascular disease showed a reduction in cardiovascular death, stroke, or myocardial infarction with a combination of rivaroxaban 2.5 mg twice daily and aspirin compared with aspirin alone.…”

Left Atrial Appendage Closure in Patients With a Mechanical Mitral Valve Prosthesis: A Multicentre Italian Pilot Study

“…LAAC effectiveness in this setting has been confirmed by a recent trial that compared the long-term benefits of LAAC concomitant to cardiac surgery [21]. Enhancement of medical therapy in such scenarios lacks of comparative trials and the decision to improve antithrombotic therapy should be weighted considering several factors such as the bleeding risk [22]. In our study, median HAS-BLED score of the enrolled population was 3, justifying an alternative therapeutic choice.…”

Review of anticoagulation options for mechanical valve prosthesis

“…Several groups have demonstrated similar effectiveness with reduced OAC therapy (compared with historically target INR of 3.0-4.5 in patients with bileaflet St. Jude Medical [St. Jude Medical, Inc., Saint Paul, MN, USA]) mechanical valves, mostly in the aortic position [21,27]. These results along with previously performed meta-analyses [16,20,26] have led to the universal recommendation of targeting INR between 2.0 and 2.5 for the aortic position and 3.0-3.5 for the mitral position [12,13]. A recent randomized clinical trial by Dong and colleagues evaluated…”

Anticoagulation for the Prevention of Arterial Thrombosis in Ambulatory Cancer Patients

“…There are several potential reasons for this null finding; first, anticoagulants alone have not been shown to be superior to antiplatelet agents for ATE prevention outside of atrial tachyarrhythmia, mechanical heart valves, and antiphospholipid antibody syndrome. 45 , 46 , 47 , 48 , 49 , 50 For example, a clinical trial involving 7,213 patients did not demonstrate a reduction in stroke recurrence among patients randomized to rivaroxaban 15 mg daily compared with aspirin after an embolic stroke of an undetermined source (5.1% vs 4.8%; HR: 1.07; P = 0.52), 48 with similar findings in the subgroup analysis of cancer patients. 47 Another clinical trial of over 27,000 patients with stable cardiovascular disease showed a reduction in cardiovascular death, stroke, or myocardial infarction with a combination of rivaroxaban 2.5 mg twice daily and aspirin compared with aspirin alone.…”