Assessment of Late Thromboembolic Complications Post-Fontan Procedure in Relation to Different Antithrombotic Regimens: 30-Years' Follow-up Experience

The Annals of Pharmacotherapy
Abdulrazaq S Al-JazairiZohair Y Alhalees

Abstract

Background: The current CHEST guidelines recommend the use of antithrombotic therapy, either aspirin or warfarin, as a primary thromboembolic complications (TECs) prophylaxis in patients who undergo Fontan procedure, without specification on drug selection or duration of therapy. Objective: To investigate the incidence rate of late TECs, occurring after 1-year post-Fontan procedure and to assess the difference in rate of late TECs between warfarin and aspirin. Methods: A retrospective cohort study included patients who had Fontan procedures between 1985-2010 at our institution. Patients were stratified according to the antithrombotic regimen-warfarin, aspirin, or no therapy-at the time of TECs. Results: We screened 499 patients who underwent Fontan procedures; 431 procedures met the inclusion criteria. Over a median follow-up of 13.6 years (IQR= 8.7), freedom from late TECs at 5, 10, 15, and 20 years was 97.54%, 96.90%, 90.78%, and 88.07%, respectively. There was no difference in late TEC incidence rates per 1000 patient-years between warfarin and aspirin: 7.82 and 5.83 events, respectively; rate ratio= 1.34 (95% CI= 0.68-2.60). Warfarin was associated with a higher major bleeding incidence rate per 1000 patient-years: 3.70 ver...Continue Reading

References

Nov 1, 1995·Circulation·D N RosenthalW E Hellenbrand
Jun 28, 2001·The Annals of Thoracic Surgery·P D CoonT L Spray
Mar 5, 2005·The Journal of Thoracic and Cardiovascular Surgery·Renate KaulitzMichael Hofbeck
Jul 12, 2005·International Journal of Cardiology·Y F CheungL C Cheng
Nov 1, 2006·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Masamichi OnoThomas Breymann
Sep 1, 2007·Pediatric Cardiology·M L Jacobs, K K Pourmoghadam
Dec 1, 2009·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Daniëlle Robbers-VisserLivia Kapusta
Mar 30, 2011·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Richard A Jonas
Jul 30, 2011·Journal of the American College of Cardiology·Paul MonagleUNKNOWN Fontan Anticoagulation Study Group
Oct 16, 2012·The Journal of Thoracic and Cardiovascular Surgery·Bartlomiej R ImielskiJames S Tweddell
Jul 3, 2013·The New England Journal of Medicine·Giancarlo AgnelliUNKNOWN AMPLIFY Investigators
Jul 25, 2013·AACN Advanced Critical Care·Marion E McRae
Jan 28, 2014·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Mohammed FirdouseTapas Mondal
Sep 1, 2015·Heart·Tarek AlsaiedGruschen R Veldtman
Sep 17, 2016·Journal of the American College of Cardiology·Alexander C EgbeDavid J Driscoll
Dec 17, 2016·American Heart Journal·Alexander C EgbeDavid J Driscoll

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