Short-term outcome of patients after transcatheter aortic valve replacement receiving different anticoagulants.
10.3760/cma.j.cn112148-20230629-00382
- Author:
Ying Hao SUN
1
;
Jie LI
1
;
Song Yuan LUO
1
;
Sheng Neng ZHENG
1
;
Jiao Hua CHEN
1
;
Ming FU
1
;
Guang LI
1
;
Rui Xin FAN
2
;
Jian Fang LUO
1
Author Information
1. Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
2. Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
- Publication Type:Journal Article
- MeSH:
Humans;
Male;
Aged;
Aged, 80 and over;
Female;
Anticoagulants/therapeutic use*;
Warfarin/therapeutic use*;
Transcatheter Aortic Valve Replacement;
Retrospective Studies;
Hemorrhage;
Stroke/epidemiology*;
Atrial Fibrillation/drug therapy*;
Treatment Outcome;
Administration, Oral
- From:
Chinese Journal of Cardiology
2023;51(8):838-843
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To compare the safety and efficacy of different anticoagulants in patients with indications for anticoagulation after transcatheter aortic valve replacement (TAVR). Methods: This is a retrospective study. Patients who underwent TAVR from April 2016 to February 2022 in Guangdong Provincial People's Hospital and had indications for anticoagulation were included and divided into two groups according to the type of anticoagulants, i.e. non-vitamin K antagonist oral anticoagulant (NOAC) and warfarin, and patients were followed up for 30 days. The primary endpoint was the combination of death, stroke, myocardial infarction, valve thrombosis, intracardiac thrombosis and major bleeding. The incidence of endpoints was compared between two groups, and multivariate logistic regression analysis was applied to adjust the bias of potential confounders. Results: A total of 80 patients were included. Mean age was (74.4±7.1) years, 43 (53.8%) were male. Forty-nine (61.3%) patients used NOAC, 31 used warfarin, and major indication for anticoagulants was atrial fibrillation (76/80, 95.0%). The adjusted risks of the primary endpoint (OR=0.23, 95%CI 0.06-0.94, P=0.040) of NOAC were lower than that of warfarin, mainly driven by a lower risk of major bleeding (OR=0.19, 95%CI 0.04-0.92, P=0.039). Conclusions: The short-term outcome of NOAC is better than that of warfarin in patients with indications for anticoagulation after TAVR. Randomized controlled trials of large sample size with long-term follow-up are needed to further testify this finding.
