Why the study?
Do low anticoagulation targets reduce bleeding events without increasing thromboembolic risk compared to standard anticoagulation targets in high-risk patients undergoing mechanical AVR with the ON-X prosthesis?
Do low anticoagulation targets reduce bleeding events without increasing thromboembolic risk compared to standard anticoagulation targets in high-risk patients undergoing mechanical AVR with the ON-X prosthesis?
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This editorial discusses the PROACT trial, which evaluates whether lower INR targets can safely reduce bleeding without increasing thromboembolic risk in patients with ON-X mechanical aortic valves.
Due to their durability, mechanical prostheses are frequently used for aortic valve replacement (AVR) in young adults. However, these valves are thrombogenic and require lifelong anticoagulation. Over the last few decades, efforts have been made towards the lowering of INR targets in an effort to reduce bleeding events without influencing the thromboembolic risk. The Prospective Randomized On-X Valve Anticoagulation Clinical Trial (PROACT) was designed to compare standard versus low anticoagulation targets in high-risk patients undergoing mechanical AVR with the ON-X prosthesis.
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Bouhout et al. (2019) studied this question.
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