Key result
Early antithrombotic therapy with aspirin after bioprosthetic aortic valve replacement in elderly patients resulted in similar rates of thromboembolic and bleeding events compared to warfarin at 3 months (p >0.999).
Why the study?
Does aspirin compared to warfarin reduce thromboembolic or bleeding events in elderly patients >60 years old after bioprosthetic AVR?
Cohort (n=479)
No
Does aspirin compared to warfarin reduce thromboembolic or bleeding events in elderly patients >60 years old after bioprosthetic AVR?
p-value: p=>0.999
Aspirin may be a feasible and easier alternative to warfarin for early antithrombotic therapy in elderly patients after bioprosthetic AVR who lack other indications for warfarin.
Aspirin was associated with similar event rates to warfarin early after bioprosthetic AVR in elderly patients; hypothesis-generating and should not yet change practice.
PURPOSE: Early antithrombotic therapy after bioprosthetic aortic valve replacement (AVR) is controversial. This study aimed to retrospectively compare between warfarin and aspirin treatment in the 3 months after bioprosthetic AVR for elderly patients more than 60 years old, and to determine the optimal antithrombotic therapy. METHODS: This retrospective study included 479 patients in single center from January 1994 to June 2014. Patients were divided into two groups (Wa group, warfarin; As group, aspirin). We searched our computerized clinical database for thromboembolic or bleeding events. Propensity score analysis was conducted to adjust for selection bias. RESULTS: All patients, except one patient, were followed-up in the out-patient department for 3 months after the operation. In all, 86 propensity-matched patient-pairs were derived. Early operative outcomes were similar in both the groups. There are one patient of thromboembolic event and three patients of bleeding events, but the prevalence was not significantly different (p >0.999). CONCLUSION: The incidence of thromboembolic and bleeding events during early 3 months after bioprosthetic AVR were similar in Wa and As groups. If the patient does not have indications of warfarin, early antithrombotic therapy with aspirin only may be easier and more feasible for elderly patients.
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Lee et al. (2017) conducted a cohort in Bioprosthetic aortic valve replacement (n=479). Aspirin vs. Warfarin was evaluated on Thromboembolic or bleeding events during the first 3 months (p=>0.999). Early antithrombotic therapy with aspirin after bioprosthetic aortic valve replacement in elderly patients resulted in similar rates of thromboembolic and bleeding events compared to warfarin at 3 months (p >0.999).
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