Key result
Moderate intensity oral anticoagulation (target INR 3) reduced major bleeding compared to moderate-high intensity (1.2 vs 3.8 per 100 patient-years, p=0.019) with similar thromboembolic rates.
Why the study?
Does moderate intensity oral anticoagulation (target INR = 3) reduce bleeding complications compared to moderate-high intensity (target INR = 4) in patients with mechanical heart valve prostheses?
Population
205 patients who had undergone mechanical heart valve substitution at least 6 months earlier, referred to…
Comparison
Moderate intensity oral anticoagulant treatment vs Moderate-high intensity oral anticoagulant…
Design
RCT, randomly assigned
Follow-up
mean 3 years
Authors
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Moderate-intensity anticoagulation was associated with less bleeding without excess thromboembolism in stable mechanical valve patients; leaves open optimal INR targets for prospective trials.
RCT (n=205)
No
Does moderate intensity oral anticoagulation (target INR = 3) reduce bleeding complications compared to moderate-high intensity (target INR = 4) in patients with mechanical heart valve prostheses?
Absolute Event Rate: 4% vs 6.9%
In patients with mechanical heart valves, a moderate intensity anticoagulation strategy (target INR 3) significantly reduces bleeding complications compared to a higher intensity strategy (target INR 4) without increasing thromboembolic risk.
Pengo et al. (1997) conducted an RCT in Mechanical heart valve prostheses (n=205). Moderate intensity oral anticoagulants vs. Moderate-high intensity oral anticoagulants (target INR = 4) was evaluated on Major bleeding, thromboembolism and vascular death. Moderate intensity oral anticoagulation (target INR 3) reduced major bleeding compared to moderate-high intensity (1.2 vs 3.8 per 100 patient-years, p=0.019) with similar thromboembolic rates.
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