Direct Oral Anticoagulant Use After Transcatheter Aortic Valve Replacement: A Case Series.
J Cardiovasc Pharmacol
; 75(1): 41-44, 2020 01.
Article
em En
| MEDLINE
| ID: mdl-31633585
ABSTRACT
BACKGROUND:
Use of an anticoagulant after transcatheter aortic valve replacement (TAVR) has been increasing in practice after noted leaflet thrombosis on dual antiplatelet therapy. As the use of anticoagulation increases so does the number of poor warfarin candidates or warfarin intolerant patients. While direct oral anticoagulant (DOAC) use is increasing for other indications, there is a paucity of data for use after TAVR. The objective of this case series is to add to the available evidence for patients who may require a DOAC after TAVR.METHODS:
A single-center, retrospective observational case series was conducted including adults 18 years of age and older who received a DOAC after TAVR between November 2008 and June 2018 at Mayo Clinic Hospital-Rochester. All patients were identified as part of the Society of Thoracic Surgeons database.RESULTS:
Twenty-one patients were identified as having received a DOAC after TAVR. Median age was 83.5 years (interquartile range 77-87), with 71% males. Within this cohort, 20 patients (95.2%) had an alternative indication for anticoagulation of either atrial fibrillation or atrial flutter. Apixaban was prescribed in 66.7% of patients, followed by rivaroxaban (14.3%), dabigatran (9.5%), and edoxaban (4.8%). No thromboembolic events were reported. Three patients experienced a bleeding event, of which only 2 occurred in the 3 months immediately after TAVR.CONCLUSIONS:
DOAC therapy after TAVR was generally safe and well tolerated. Taken in context of other retrospective studies, these data suggest that the presence of valvular heart disease, specifically TAVR in this case, should not preclude the use of DOACs.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Valva Aórtica
/
Estenose da Valva Aórtica
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Fibrilação Atrial
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Flutter Atrial
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Tromboembolia
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Antitrombinas
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Inibidores do Fator Xa
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Substituição da Valva Aórtica Transcateter
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Aged80
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Female
/
Humans
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Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Cardiovasc Pharmacol
Ano de publicação:
2020
Tipo de documento:
Article