Antiplatelet versus oral anticoagulant therapy as antithrombotic prophylaxis after mitral valve repair

The Journal of Thoracic and Cardiovascular Surgery
Domenico PaparellaGIROC Investigators

Abstract

To verify the rate of thromboembolic and hemorrhagic complications during the first 6 months after mitral valve repair and to assess whether the type of antithrombotic therapy influenced clinical outcome. Retrospective data were retrieved from 19 centers. Inclusion criteria were isolated mitral valve repair with ring implantation. Exclusion criteria were ongoing or past atrial fibrillation and any combined intraoperative surgical procedures. The study cohort consisted of 1882 patients (aged 58 ± 15 years; 36% women), and included 1517 treated with an oral anticoagulant (VKA group) and 365 with antiplatelet drugs (APLT group). Primary efficacy outcome was the incidence of arterial thromboembolic events within 6 months and primary safety outcome was the incidence of major bleeding within 6 months. Propensity matching was performed to obtain 2 comparable cohorts (858 vs 286). No differences were detected for arterial embolic complications in matched cohort (1.6% VKA vs 2.1% APLT; P = .50). Conversely, patients in the APLT group showed lower incidence of major bleeding complications (3.9% vs 0.7%; P = .01). Six-month mortality rate was significantly higher in the VKA group (2.7% vs 0.3%; P = .02). Multivariable analysis in the matc...Continue Reading

References

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Citations

Feb 3, 2016·The Journal of Thoracic and Cardiovascular Surgery·Leonid Sternik
Apr 3, 2018·Cardiology in Review·E Anne RussellGraeme P Maguire
Apr 3, 2018·Cardiology in Review·Abdallah SanaaniJoseph M Harburger
Aug 3, 2020·Journal of Cardiac Surgery·Tessa M F Watt The Michigan Mitral Research Group Mmrg
Aug 23, 2018·Journal of Thrombosis and Thrombolysis·Sake J van der WallMenno V Huisman
Sep 18, 2020·Journal of Cardiac Surgery·Joel AikinsAmer Harky
Jan 1, 2019·Indian Journal of Thoracic and Cardiovascular Surgery : Official Organ, Association of Thoracic and Cardiovascular Surgeons of India·Devendra SaksenaUNKNOWN VHD India consensus committee
Oct 22, 2020·Heart, Lung & Circulation·Evangelos PapadimasKristine L K Teoh
Aug 24, 2021·Frontiers in Cardiovascular Medicine·Andreas VerstraetePeter Verhamme

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