Adherence to American College of Cardiology/American Heart Association guidelines for the management of anticoagulation in patients with mechanical valves undergoing elective outpatient procedures

The American Journal of Cardiology
Ajay J KirtaneWarren J Manning

Abstract

This study sought to establish the practice patterns of a diverse group of academic physicians, in the management of periprocedural anticoagulation for patients with mechanical heart valves, to study adherence to American College of Cardiology/American Heart Association (ACC/AHA) guidelines. Physicians (n = 140) were surveyed to assess strategies for the periprocedural anticoagulation of patients with bileaflet mechanical heart valves undergoing 2 common outpatient procedures. Six patient scenarios with graded risk profiles were presented for each valve location (mitral and aortic). In >90% of high-risk patient scenarios, for which the ACC/AHA guidelines recommend periprocedural anticoagulation, anticoagulation was recommended, with minimal differences between physician specialties. However, periprocedural anticoagulation was also recommended in >70% of non-high-risk scenarios, for which the ACC/AHA guidelines recommend no periprocedural anticoagulation. Noncardiologists recommended anticoagulation more often in non-high-risk patients (p <0.01), especially for patients with aortic valve prostheses. Thus, academic physicians appropriately recommend periprocedural anticoagulation for high-risk patients with mechanical heart valve...Continue Reading

Citations

Dec 4, 2014·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Mauro BrunoClaudio De Angelis
Nov 10, 2012·American Heart Journal·Brett D AtwaterEric D Peterson
Nov 27, 2007·Expert Review of Cardiovascular Therapy·Mark S Slaughter, Eias Jweied

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