PMID: 26771732Jan 16, 2016Paper

Is low anticoagulation intensity more beneficial for patients with bileaflet mechanical mitral valves? A meta-analysis

The Journal of Cardiovascular Surgery
Zhe XuXi Zhang

Abstract

For the mitral valve replacement (MVR) using the lowest thrombogenic risk bileaflet valves (St. Jude Medical [St Paul, MN, USA], Carbomedics [Austin, TX, USA] and On-X [Austin, TX, USA]), excellent results can be achieved by adopting the anticoagulation intensity (median INR<2.5) which is lower than the recommended intensity (INR:2.5~3.5). Our aim was to provide a pooled estimate of potential benefit from clinical studies using low anticoagulation intensity and high intensity in these patients. Relevant studies published before February 2014 were searched through a number of digital databases (MEDLINE, EMBASE, Cochrane Library, etc.). They were pooled by SPSS19.0 using the random effect method in three fields: occurrence rate of major thromboembolism, major hemorrhage and major total events. Fourteen studies with 3595 patients were included. The follow-up period was 12,846.6 patient-years. Pooled estimates indicated reduction in major hemorrhage (RR:0.420, 95%CI: 0.296~0.595, P<0.001) and major total events (RR: 0.738, 95%CI: 0.604~0.902, P=0.003) in the low intensity group. No difference was noted in major thromboembolism (RR: 1.045, 95%CI: 0.814~1.341, P=0.75). Compared with the recommended high intensity, low anticoagulation...Continue Reading

Related Concepts

Related Feeds

Antianginal Drugs: Mechanisms of Action

Antianginal drugs, including nitrates, beta-blockers, and calcium channel blockers, are used in the treatment of angina pectoris. Here is the latest research on their use and their mechanism of action.

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.