January 1, 1995Stroke
Monitoring Combined Antithrombotic Treatments in Patients With Prosthetic Heart Valves Using Transcranial Doppler and Coagulation Markers
Why the study?
Does the addition of aspirin or heparin to coumarin reduce cerebral embolic signals in patients with mechanical prosthetic heart valves and recurrent cerebral ischemia?
Population
5 patients with mechanical prosthetic heart valves suffering from recurrent cerebral ischemic symptoms…
Comparison
Addition of intravenous and oral aspirin or… vs Coumarin alone (baseline values).
Design
Case_series
Follow-up
10 days
Authors
Discussion
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Implication
No embolic benefit from added aspirin or heparin in this case; leaves open need for controlled trials in mechanical valves.
Structured PICO
Does the addition of aspirin or heparin to coumarin reduce cerebral embolic signals in patients with mechanical prosthetic heart valves and recurrent cerebral ischemia?
P
Population
5 patients with mechanical prosthetic heart valves suffering from recurrent cerebral ischemic symptoms despite adequate anticoagulant therapy (INR 3.0 to 4.3).
I
Intervention
Addition of intravenous (500 mg bolus) and oral (100 mg/d for 10 days) aspirin or intravenous (5000 IU bolus) heparin to coumarin therapy.
C
Comparator
Coumarin alone (baseline values).
O
Outcome
Frequency of embolic signals in both middle cerebral arteries monitored using a two-channel 2-MHz transcranial Doppler system.surrogate
The addition of aspirin or heparin to coumarin did not reduce the rate of cerebral emboli measured by transcranial Doppler in high-risk patients with mechanical prosthetic valves.
Cite This Study
Sturzenegger et al. (1995) studied this question.