Key result
In 30 adults with congenital heart disease, NOAC therapy over a median of 17 months resulted in zero thromboembolic events and one major bleeding event (annual rate 1.58%).
Why the study?
Adults with congenital heart disease have an increased risk of thromboembolic complications and arrhythmias, but studies evaluating the efficacy and safety of NOACs in this population are scarce.
Does NOAC therapy prevent thromboembolic events and minimize bleeding in adults with congenital heart disease?
Observational (n=30)
No
Does NOAC therapy prevent thromboembolic events and minimize bleeding in adults with congenital heart disease?
In a small cohort of adults with congenital heart disease, NOAC therapy appeared safe and effective, with no thromboembolic events and only one major bleeding event over a median 17 months of follow-up.
Background Adults with congenital heart disease (ACHD) are a group with an increased risk of thromboembolic complications and arrhythmias. Vitamin K antagonists are the most commonly used thromboprophylaxis therapy in this population. Studies on the efficacy and safety of novel oral anticoagulants (NOAC) are scare in ACHD. A retrospective study on ACHD patients on NOAC treatment registered in the National Quality Registry for Congenital Heart Disease, SWEDCON, and National Quality Registry for Atrial fibrillation and Anticoagulation, AuriculA, from Southern Sweden. Results Thirty patients who had been taking NOAC treatment for a minimum of 3 months were included. Their median age was 55 years (SD 17 years) and 57% were male. Median follow-up was 17 months (IQR: 10–41). Eliquis was the most used NOAC (47%). Median CHA 2 DS 2 -VASc score was 2 (IQR: 0–3) and HAS-BLED was 1 (IQR: 0–2). Complex ACHD was prevalent in 27% of the patients. No thromboembolic events were recorded; however, one major bleeding, unspecified, was reported during the total cumulative patient follow-up time of 64 years. Conclusions The results of our study, although limited in size, suggest that NOAC appear safe and effective in ACHD patients. Further and larger studies on NOAC in ACHD patients are warranted.
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Samarai et al. (2023) conducted an observational in Adults with congenital heart disease (ACHD) (n=30). Novel oral anticoagulants (NOAC) was evaluated on Thromboembolic events and major bleeding events (95% CI 0.08-7.78). In 30 adults with congenital heart disease, NOAC therapy over a median of 17 months resulted in zero thromboembolic events and one major bleeding event (annual rate 1.58%).
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