PMID: 9159625May 1, 1997Paper

Low-intensity oral anticoagulation plus low-dose aspirin versus high-intensity oral anticoagulation alone: a randomized trial in patients with mechanical prosthetic heart valves

The Journal of Thoracic and Cardiovascular Surgery
S S MeschengieserM A Lazzari

Abstract

Mechanical heart valve replacement requires lifelong anticoagulant treatment. Aspirin has proved useful in further reducing thromboembolic events when added to oral anticoagulants. However, increased (gastrointestinal) bleeding was observed at the doses previously tested for this combination in heart valve prostheses. We performed a prospective randomized trial to compare the combination of low-intensity oral anticoagulants (international normalized ratio 2.5 to 3.5) plus aspirin (100 mg/day) (arm A) versus high-intensity oral anticoagulants alone (arm B) (international normalized ratio 3.5 to 4.5). Arm A included 258 patients and arm B 245 patients. The two groups were comparable for all baseline characteristics. The outcomes of the study were embolism, valve thrombosis, and major hemorrhage. The median follow-up was 23 months. The two treatments offered similar antithrombotic protection. The incidence of embolic episodes was 1.32 per 100 patient-years (95% confidence interval 0.53 to 2.7) for arm A and 1.48 per 100 patient-years (95% confidence interval 0.59 to 3.03) for arm B. Major hemorrhage occurred in 1.13 per 100 patient-years (95% confidence interval 0.41 to 2.45) for arm A and 2.33 per 100 patient-years (95% confidenc...Continue Reading

References

Jul 1, 1991·British Journal of Clinical Pharmacology·A B HawthorneC J Hawkey
Aug 19, 1993·The New England Journal of Medicine·A G TurpieJ Hirsh

❮ Previous
Next ❯

Citations

Mar 8, 2000·American Journal of Hematology·P CasaisM A Lazzari
Dec 7, 2007·Journal of Thrombosis and Thrombolysis·Robert W EmeryJay G Shake
Jun 3, 2008·Journal of Thrombosis and Thrombolysis·A LoualidiM C H Janssen
Feb 12, 2010·Internal and Emergency Medicine·Maria Cristina VedovatiGiancarlo Agnelli
Nov 30, 2000·Current Treatment Options in Neurology·K Vahedi, P Amarenco
Apr 1, 2008·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Joel DunningUNKNOWN EACTS Audit and Guidelines Committee
Aug 4, 1999·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·W R JamiesonS V Lichtenstein
Aug 27, 2005·Nature Clinical Practice. Cardiovascular Medicine·Detlef HeringDieter Horstkotte
Sep 1, 2001·British Journal of Haematology·M Makris, H G Watson
Jun 23, 1999·Heart·S S MeschengieserM A Lazzari
Mar 30, 2005·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Patricia CasaisMaria A Lazzari
Jun 13, 2009·Current Opinion in Cardiology·Ralph A H Stewart
Jul 24, 2002·Circulation Journal : Official Journal of the Japanese Circulation Society·Katsuhiko MatsuyamaTakehiko Matsuo
Jul 3, 1999·Pharmacotherapy·R SunderjiK Gin
Sep 11, 2014·European Heart Journal·Bernard Iung, Josep Rodés-Cabau
Jul 10, 2004·Journal of General Internal Medicine·Robin J Larson, Elliott S Fisher
Jan 30, 2007·Current Medical Research and Opinion·Angel Lanas, James Scheiman
Dec 1, 2012·Indian Heart Journal·Rajiv BajajT S Mahant
Jun 28, 2011·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Angel LanasEdward J Mills
Aug 9, 2011·Stroke Research and Treatment·M Àngels FontAdrià Arboix
Jul 18, 2015·Archives of Cardiovascular Diseases·Laurent FauchierAnne Bernard
Aug 21, 2010·Journal of Thrombosis and Haemostasis : JTH·L LinkinsC Kearon
Mar 31, 2016·Applied Health Economics and Health Policy·Manal H El-HamamsyHossam Elmansy
Dec 27, 2013·Circulation Journal : Official Journal of the Japanese Circulation Society·UNKNOWN JCS Joint Working Group
Dec 19, 2003·Journal of the American College of Cardiology·Roel VinkMarcel Levi
May 23, 1998·Blood Reviews·A C Butler, R C Tait
May 11, 2007·Expert Review of Cardiovascular Therapy·Roel VinkMarcel Levi

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.