Comparison of anticoagulation regimens after Carpentier-Edwards aortic or mitral valve replacement
To identify the optimal use of anticoagulants after Carpentier-Edwards valve replacement, a retrospective study of all patients undergoing Carpentier-Edwards aortic (N = 378) or mitral (N = 370) valve replacement was done. At the time of hospital discharge, 103 patients were managed with warfarin, 5...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 1994-11, Vol.90 (5 Pt 2), p.II214 |
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| container_title | Circulation (New York, N.Y.) |
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| creator | Blair, K L Hatton, A C White, W D Smith, L R Lowe, J E Wolfe, W G Young, W G Oldham, H N Douglas, Jr, J M Glower, D D |
| description | To identify the optimal use of anticoagulants after Carpentier-Edwards valve replacement, a retrospective study of all patients undergoing Carpentier-Edwards aortic (N = 378) or mitral (N = 370) valve replacement was done.
At the time of hospital discharge, 103 patients were managed with warfarin, 509 with aspirin alone, and 136 with no anticoagulation or antiplatelet therapy. Over the first 90 days after aortic or mitral valve replacement, the linearized rate of hemorrhage was greater for warfarin than for aspirin or no therapy (16.7 +/- 7.6%, 3.4 +/- 1.7%, and 3.1 +/- 3.1% per patient-year, respectively; P = .03). After aortic valve replacement, aspirin provided a low rate of thromboembolism (0.8 +/- 0.2% per patient-year), not significantly different from warfarin or no treatment (2.9 +/- 1.6% and 1.5 +/- 0.6% per patient-year) (P = .07). After mitral valve replacement, no single treatment was most advantageous because the rate of hemorrhage over the first 90 days for warfarin was equivalent to the 90-day rate of thromboembolism with aspirin or no therapy.
Anticoagulation after Carpentier-Edwards mitral valve replacement may be best guided by individual patient characteristics. Within the limits of a retrospective analysis, these data support the routine use of aspirin alone after Carpentier-Edwards aortic valve replacement, both in the first 90 days and long-term. |
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At the time of hospital discharge, 103 patients were managed with warfarin, 509 with aspirin alone, and 136 with no anticoagulation or antiplatelet therapy. Over the first 90 days after aortic or mitral valve replacement, the linearized rate of hemorrhage was greater for warfarin than for aspirin or no therapy (16.7 +/- 7.6%, 3.4 +/- 1.7%, and 3.1 +/- 3.1% per patient-year, respectively; P = .03). After aortic valve replacement, aspirin provided a low rate of thromboembolism (0.8 +/- 0.2% per patient-year), not significantly different from warfarin or no treatment (2.9 +/- 1.6% and 1.5 +/- 0.6% per patient-year) (P = .07). After mitral valve replacement, no single treatment was most advantageous because the rate of hemorrhage over the first 90 days for warfarin was equivalent to the 90-day rate of thromboembolism with aspirin or no therapy.
Anticoagulation after Carpentier-Edwards mitral valve replacement may be best guided by individual patient characteristics. Within the limits of a retrospective analysis, these data support the routine use of aspirin alone after Carpentier-Edwards aortic valve replacement, both in the first 90 days and long-term.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>PMID: 7955256</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Aortic Valve ; Aspirin - therapeutic use ; Atrial Fibrillation - epidemiology ; Bioprosthesis ; Female ; Follow-Up Studies ; Heart Valve Prosthesis ; Hemorrhage - chemically induced ; Hemorrhage - epidemiology ; Humans ; Incidence ; Male ; Mitral Valve ; Postoperative Complications - epidemiology ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Thromboembolism - epidemiology ; Thromboembolism - prevention & control ; Time Factors ; Warfarin - therapeutic use</subject><ispartof>Circulation (New York, N.Y.), 1994-11, Vol.90 (5 Pt 2), p.II214</ispartof><rights>Copyright American Heart Association, Inc. Nov 1994</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7955256$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Blair, K L</creatorcontrib><creatorcontrib>Hatton, A C</creatorcontrib><creatorcontrib>White, W D</creatorcontrib><creatorcontrib>Smith, L R</creatorcontrib><creatorcontrib>Lowe, J E</creatorcontrib><creatorcontrib>Wolfe, W G</creatorcontrib><creatorcontrib>Young, W G</creatorcontrib><creatorcontrib>Oldham, H N</creatorcontrib><creatorcontrib>Douglas, Jr, J M</creatorcontrib><creatorcontrib>Glower, D D</creatorcontrib><title>Comparison of anticoagulation regimens after Carpentier-Edwards aortic or mitral valve replacement</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>To identify the optimal use of anticoagulants after Carpentier-Edwards valve replacement, a retrospective study of all patients undergoing Carpentier-Edwards aortic (N = 378) or mitral (N = 370) valve replacement was done.
At the time of hospital discharge, 103 patients were managed with warfarin, 509 with aspirin alone, and 136 with no anticoagulation or antiplatelet therapy. Over the first 90 days after aortic or mitral valve replacement, the linearized rate of hemorrhage was greater for warfarin than for aspirin or no therapy (16.7 +/- 7.6%, 3.4 +/- 1.7%, and 3.1 +/- 3.1% per patient-year, respectively; P = .03). After aortic valve replacement, aspirin provided a low rate of thromboembolism (0.8 +/- 0.2% per patient-year), not significantly different from warfarin or no treatment (2.9 +/- 1.6% and 1.5 +/- 0.6% per patient-year) (P = .07). After mitral valve replacement, no single treatment was most advantageous because the rate of hemorrhage over the first 90 days for warfarin was equivalent to the 90-day rate of thromboembolism with aspirin or no therapy.
Anticoagulation after Carpentier-Edwards mitral valve replacement may be best guided by individual patient characteristics. Within the limits of a retrospective analysis, these data support the routine use of aspirin alone after Carpentier-Edwards aortic valve replacement, both in the first 90 days and long-term.</description><subject>Aortic Valve</subject><subject>Aspirin - therapeutic use</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Bioprosthesis</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Valve Prosthesis</subject><subject>Hemorrhage - chemically induced</subject><subject>Hemorrhage - epidemiology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Mitral Valve</subject><subject>Postoperative Complications - epidemiology</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Thromboembolism - epidemiology</subject><subject>Thromboembolism - prevention & control</subject><subject>Time Factors</subject><subject>Warfarin - therapeutic use</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNotkE1LxDAQhoMo67r6E4TgvZBMmrY5Slk_YMGLnsvka-nSNjVNV_z3BtzTMPM-zwzMFdlyCWVRSqGuyZYxpopaANySu2U55bYStdyQTa2kBFltiW7DOGPslzDR4ClOqTcBj-uAqc-j6I796KaFok8u0hbj7DLiYrG3PxhtDkLMCg2Rjn2KONAzDmeXxXlA47Kb7smNx2FxD5e6I18v-8_2rTh8vL63z4diBlamQiIHqS3XWpVS-sYIhQaMb2pWaW9NCdxq77h0yupGefAVGMWt4tCAEY3Ykaf_vXMM36tbUncKa5zyyQ441IzJRmbo8QKtenS2m2M_YvztLg8Rf3krX0o</recordid><startdate>19941101</startdate><enddate>19941101</enddate><creator>Blair, K L</creator><creator>Hatton, A C</creator><creator>White, W D</creator><creator>Smith, L R</creator><creator>Lowe, J E</creator><creator>Wolfe, W G</creator><creator>Young, W G</creator><creator>Oldham, H N</creator><creator>Douglas, Jr, J M</creator><creator>Glower, D D</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope></search><sort><creationdate>19941101</creationdate><title>Comparison of anticoagulation regimens after Carpentier-Edwards aortic or mitral valve replacement</title><author>Blair, K L ; Hatton, A C ; White, W D ; Smith, L R ; Lowe, J E ; Wolfe, W G ; Young, W G ; Oldham, H N ; Douglas, Jr, J M ; Glower, D D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p204t-5a125bd1bb9455f8c39ac2cf8706bfdc421dbfe15e9db89f2f62c91d91282c383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Aortic Valve</topic><topic>Aspirin - therapeutic use</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Bioprosthesis</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Valve Prosthesis</topic><topic>Hemorrhage - chemically induced</topic><topic>Hemorrhage - epidemiology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Mitral Valve</topic><topic>Postoperative Complications - epidemiology</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Thromboembolism - epidemiology</topic><topic>Thromboembolism - prevention & control</topic><topic>Time Factors</topic><topic>Warfarin - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Blair, K L</creatorcontrib><creatorcontrib>Hatton, A C</creatorcontrib><creatorcontrib>White, W D</creatorcontrib><creatorcontrib>Smith, L R</creatorcontrib><creatorcontrib>Lowe, J E</creatorcontrib><creatorcontrib>Wolfe, W G</creatorcontrib><creatorcontrib>Young, W G</creatorcontrib><creatorcontrib>Oldham, H N</creatorcontrib><creatorcontrib>Douglas, Jr, J M</creatorcontrib><creatorcontrib>Glower, D D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Blair, K L</au><au>Hatton, A C</au><au>White, W D</au><au>Smith, L R</au><au>Lowe, J E</au><au>Wolfe, W G</au><au>Young, W G</au><au>Oldham, H N</au><au>Douglas, Jr, J M</au><au>Glower, D D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of anticoagulation regimens after Carpentier-Edwards aortic or mitral valve replacement</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>1994-11-01</date><risdate>1994</risdate><volume>90</volume><issue>5 Pt 2</issue><spage>II214</spage><pages>II214-</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>To identify the optimal use of anticoagulants after Carpentier-Edwards valve replacement, a retrospective study of all patients undergoing Carpentier-Edwards aortic (N = 378) or mitral (N = 370) valve replacement was done.
At the time of hospital discharge, 103 patients were managed with warfarin, 509 with aspirin alone, and 136 with no anticoagulation or antiplatelet therapy. Over the first 90 days after aortic or mitral valve replacement, the linearized rate of hemorrhage was greater for warfarin than for aspirin or no therapy (16.7 +/- 7.6%, 3.4 +/- 1.7%, and 3.1 +/- 3.1% per patient-year, respectively; P = .03). After aortic valve replacement, aspirin provided a low rate of thromboembolism (0.8 +/- 0.2% per patient-year), not significantly different from warfarin or no treatment (2.9 +/- 1.6% and 1.5 +/- 0.6% per patient-year) (P = .07). After mitral valve replacement, no single treatment was most advantageous because the rate of hemorrhage over the first 90 days for warfarin was equivalent to the 90-day rate of thromboembolism with aspirin or no therapy.
Anticoagulation after Carpentier-Edwards mitral valve replacement may be best guided by individual patient characteristics. Within the limits of a retrospective analysis, these data support the routine use of aspirin alone after Carpentier-Edwards aortic valve replacement, both in the first 90 days and long-term.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>7955256</pmid></addata></record> |
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| identifier | ISSN: 0009-7322 |
| ispartof | Circulation (New York, N.Y.), 1994-11, Vol.90 (5 Pt 2), p.II214 |
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| language | eng |
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| source | MEDLINE; American Heart Association Journals; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Aortic Valve Aspirin - therapeutic use Atrial Fibrillation - epidemiology Bioprosthesis Female Follow-Up Studies Heart Valve Prosthesis Hemorrhage - chemically induced Hemorrhage - epidemiology Humans Incidence Male Mitral Valve Postoperative Complications - epidemiology Proportional Hazards Models Retrospective Studies Risk Factors Thromboembolism - epidemiology Thromboembolism - prevention & control Time Factors Warfarin - therapeutic use |
| title | Comparison of anticoagulation regimens after Carpentier-Edwards aortic or mitral valve replacement |
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