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Non-vitamin K versus vitamin K antagonist oral anticoagulants in surgical mitral valve repair or bioprosthetic valve replacement in the first three months after surgery

2024-09Journal article Open access
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dc.contributor.authorCosta, Hugo
dc.contributor.authorCustódio, Pedro
dc.contributor.authorGonçalves, Rui Baptista
dc.contributor.authorMagro, Pedro Lamares
dc.contributor.authorUva, Miguel Sousa
dc.date.accessioned2024-11-27T13:31:44Z
dc.date.available2024-11-27T13:31:44Z
dc.date.issued2024-09
dc.description.abstractIntroduction and Objectives: Oral anticoagulation (OAC) with non-vitamin K antagonist oral anticoagulants (NOACs) after surgical mitral valve repair (MVR) or bioprosthetic valve replacement (BVR) in mitral position remains a controversial topic among the cardiovascular community, in particular in the early postoperative period. This study aimed to evaluate the efficacy and safety of NOACs in the first three months after MVR or mitral BVR compared to vitamin K antagonists (VKAs). Methods: This was a single-center retrospective study with prospectively collected periintervention outcomes between 2020 and 2021. Records were retrieved and all participants were contacted by telephone. Patients were divided into groups according to OAC strategy. The primary outcome was a composite of death, rehospitalization, myocardial infarction, stroke or transient ischemic attack, systemic embolism, mitral thrombosis, or bleeding during the first three months after surgery. Results: A total of 148 patients were enrolled, with a mean age of 65.5 +/- 12.2 years, 56.8% male. On discharge, 98 (66.2%) patients were on VKAs and 50 (33.8%) were on DOACs for at least three months. The primary outcome occurred in 22 (22.4%) patients in the VKA group and in three (6%) in the NOAC group (p=0.012), mainly driven by more bleeding events in the former. Independent predictors of the primary outcome were smoking (p=0.028) and OAC with VKAs at discharge, the latter predicting three times more events (p=0.046, OR 3.72, 95% CI 1.02-13.5). Conclusions: NOACs were associated with fewer events, supporting their efficacy and safety during the first three months after surgical MVR or mitral BVR.eng
dc.identifier.doi10.1016/j.repc.2024.02.013
dc.identifier.issn0870-2551
dc.identifier.urihttp://hdl.handle.net/10400.1/26352
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.relation.hasversionhttps://www.sciencedirect.com/science/article/pii/S0870255124001884?via%3Dihub
dc.relation.ispartofRevista Portuguesa de Cardiologia
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectNon-vitamin K antagonist oral anticoagulants
dc.subjectMitral valve repair
dc.subjectMitral bioprosthetic valve replacement
dc.subjectFirst three months after surgery
dc.titleNon-vitamin K versus vitamin K antagonist oral anticoagulants in surgical mitral valve repair or bioprosthetic valve replacement in the first three months after surgeryeng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage509
oaire.citation.issue9
oaire.citation.startPage501
oaire.citation.titleRevista Portuguesa de Cardiologia
oaire.citation.volume43
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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