Mechanical Valve Thrombosis on Rivaroxaban: Are Novel Anticoagulants
                        Really an Option?

Kumar, Vishesh; Kelly, Shawn; Raizada, Amol; Yee, Jimmy; Anuwatworn, Amornpol; Styś, Adam; Stys, Maria

doi:10.14797/mdcj-13-2-73

Cited by 9 publications

(5 citation statements)

References 7 publications

(7 reference statements)

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“…The exact mechanism of corresponding findings was unknown, but some researchers [25, 26] reported there was microthrombi formation on bioprosthetic valve after NOAC administration. Sun, Davidson, Lamy & Eikelboom et al (2009) [24] proposed that thrombogenicity may result from altered blood flow, iatrogenic tissue injury and exposed surgical material (e.g.…”

Section: Discussionmentioning

confidence: 99%

Comparing clinical outcomes of NOACs with warfarin on atrial fibrillation with Valvular heart diseases: a meta-analysis

Sze

Shum

et al. 2019

BMC Cardiovasc Disord

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Background Warfarin is the standard of care and NOAC (Novel oral anticoagulants) are a group of newer drugs for such purposes. NOAC has a generally better profile (Clear interaction, less side effect, require less monitoring). However, its efficacy on valvular atrial fibrillation remains unclear. Method We researched literature articles from Embase, Cochrane and PubMed. Then we meta-analysed these six articles to assess pooled estimate of relative risk (RR) and 95% confidence intervals (Cl) using random-effects model for stroke, systemic embolic event, major bleeding and all-cause mortality. Heterogeneity across study was tested with Cochran’s Q Test and I 2 Test. The bias of studies was first tested by examining the symmetry of Funnel Plot. Cochrane’s Collaboration Tool was also used to report any presented bias. Results We collected 496 articles in total and finally we included six articles in our meta-analysis. For SSEE (Stroke, Systemic Embolic Event), the pooled relative risk showed a significantly better clinical outcome of NOAC (RR: 0.66; 95% CI: 0.46 to 0.95). However, there is no significant difference in major bleeding (RR: 0.714, 95% CI:0.46 to 1.11) and all-cause mortality (RR: 0.84, 95% CI: 0.58 to 1.21). Conclusion Compared to Warfarin, NOAC is significantly more protective against the embolic event, but no significant difference in lowering risk of major bleeding, all-cause mortality or all aspects of post-TAVI (Trans-catheter aortic valve implantation). Electronic supplementary material The online version of this article (10.1186/s12872-019-1089-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Comparing clinical outcomes of NOACs with warfarin on atrial fibrillation with Valvular heart diseases: a meta-analysis

Sze

Shum

et al. 2019

BMC Cardiovasc Disord

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“…In the RIWA study, 15 mg of rivaroxaban twice daily exhibited similar numbers of bleeding and thromboembolic events compared with warfarin. 7 However, contrary to the aforementioned study, thrombolytic 8 and even fatal 9 outcomes have been described. Furthermore, apixaban demonstrated comparable efficacy in preclinical AVR models.…”

Section: Introductionmentioning

confidence: 80%

Analysis of Anticoagulation Therapy and Anticoagulation-Related Outcomes Among Asian Patients After Mechanical Valve Replacement

Huang

Chan

et al. 2022

JAMA Netw Open

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“… 17 There was a case report where a patient who underwent mechanical aortic valve replacement was administered the oral anticoagulant rivaroxaban instead of warfarin, which caused a significant gradient and thrombosis on one leaflet of the valve. 18 This patient died due to complications from the thrombotic valve. However, for this patient with FX deficiency, she had not been taking any anticoagulants and did not have any complications due to the mechanical valve.…”

Section: Discussionmentioning

confidence: 99%

Mechanical valve replacement without anticoagulation: a case report

Wang

Lin

et al. 2021

European Heart Journal - Case Reports

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Background For patients who undergo mechanical valve replacement, the greatest disadvantage is that they require long-term or permanent use of anticoagulant therapy to prevent thromboembolism. To date, mechanical valve replacement without anticoagulation has been published in the literature. Case summary We present the case of a 75-year-old female who underwent mechanical mitral valve replacement (MVR) on mid-June, 2007. However, this patient had not been taking anticoagulant medication since she experienced warfarin overdose in the first month after the operation. She had been well without using any anticoagulation, and there were no complications of the mechanical valve. Discussion There was no thrombosis for such a long period of time because she suffered from FX deficiency. To the best of our knowledge, she may be the only patient who has been well without any anticoagulation since not taking warfarin 12 years ago.

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Mechanical Valve Thrombosis on Rivaroxaban: Are Novel Anticoagulants Really an Option?

Cited by 9 publications

References 7 publications

Comparing clinical outcomes of NOACs with warfarin on atrial fibrillation with Valvular heart diseases: a meta-analysis

Comparing clinical outcomes of NOACs with warfarin on atrial fibrillation with Valvular heart diseases: a meta-analysis

Analysis of Anticoagulation Therapy and Anticoagulation-Related Outcomes Among Asian Patients After Mechanical Valve Replacement

Mechanical valve replacement without anticoagulation: a case report

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