Low Molecular Weight Heparin After Mechanical Heart Valve Replacement
Key result
Low molecular weight heparin after mechanical heart valve replacement achieved therapeutic anticoagulation on day 2 in 87% of patients compared to 9% with unfractionated heparin (P<0.0001).
Why the study?
Does subcutaneous low molecular weight heparin improve the achievement of therapeutic anticoagulation levels compared to unfractionated heparin in patients after mechanical heart valve replacement?
Population
208 consecutive patients who underwent a single or double heart valve replacement with mechanical prostheses
Comparison
Low molecular weight heparin administered… vs Unfractionated heparin administered…
Design
Cohort
Follow-up
mean 13.6 to 14.1 days
Authors
Discussion
Loading...
Member takes
Implication
LMWH may enable more reliable early anticoagulation after mechanical valve replacement; leaves open whether this improves outcomes in randomized trials.
Study Design
Type
Cohort (n=208)
Structured PICO
Does subcutaneous low molecular weight heparin improve the achievement of therapeutic anticoagulation levels compared to unfractionated heparin in patients after mechanical heart valve replacement?
P
Population
208 consecutive patients who underwent single or double mechanical heart valve replacement, treated with unfractionated heparin or low molecular weight heparin for approximately 14 days.
E
Exposure
Low molecular weight heparin (LMWH) administered subcutaneously for a mean duration of 14.1+/-0.6 days
C
Comparator
Unfractionated heparin (UH) administered subcutaneously for a mean duration of 13.6+/-0.5 days
O
Outcome
Proportion of patients with anticoagulation levels within the therapeutic range (anti-Xa 0.5 to 1 IU/mL for LMWH; aPTT 1.5 to 2.5 times control for UH) on the second day of treatmentsurrogate
Main Result
Absolute Event Rate: 87% vs 9%
p-value: p=<0.0001
LMWH provides more rapid and reliable therapeutic anticoagulation compared to subcutaneous unfractionated heparin in the early postoperative period after mechanical heart valve replacement.
Limitations
- Nonrandomized study design
- Nonrandomized design
Cite This Study
Montalescot et al. (2000) conducted a cohort in Mechanical heart valve replacement (n=208). Low molecular weight heparin (LMWH) vs. Unfractionated heparin (UH) was evaluated on Therapeutic anticoagulation on the second day of treatment (anti-Xa activity 0.5-1 IU/mL for LMWH vs aPTT 1.5-2.5 times control for UH) (p=<0.0001). Low molecular weight heparin after mechanical heart valve replacement achieved therapeutic anticoagulation on day 2 in 87% of patients compared to 9% with unfractionated heparin (P<0.0001).