Key result
In Japanese AF patients with bioprosthetic valves, antithrombotic therapy resulted in stroke/systemic embolism at 1.77 per 100 person-years and major bleeding at 2.83 per 100 person-years.
Why the study?
Antithrombotic therapy guidelines for patients with atrial fibrillation and bioprosthetic valves vary by country, likely due to a lack of robust study data.
Observational (n=214)
Yes
In a Japanese real-world registry of atrial fibrillation patients with bioprosthetic valves, warfarin remains the dominant antithrombotic therapy, though DOAC use is increasing.
Supports risk discussions in Japanese AF patients with bioprosthetic valves; leaves open optimal regimen pending randomized trials.
BACKGROUND: The incidence of cardiovascular diseases, including valvular heart disease and atrial fibrillation (AF), is rising as the elderly population increases. For patients with AF and bioprosthetic valves, current treatment guidelines for antithrombotic therapy vary by country, likely due to a lack of robust study data. METHODS: We conducted a multicenter, retrospective, observational analysis of 214 Japanese AF patients after bioprosthetic valve replacement in real-world clinical practice. The primary efficacy endpoint was the incidence of stroke/systemic embolism, and the primary safety endpoint was major bleeding. RESULTS: The mean observation period was 46.0 months. Warfarin was administered to 176 patients (82.2%), direct oral anticoagulants (DOAC) to 16 patients (7.5%), and antiplatelet drugs to 13 patients (6.1%). The number of patients who were treated with DOAC was increasing in the later period of registration. Stroke/systemic embolism was observed in 14 patients [1.77 patients/100 person-years (PY)]. Major bleeding was observed in 22 patients (2.83/100 PY). CONCLUSIONS: In a current real-world setting in Japan, warfarin was the most commonly used treatment in AF patients with bioprosthetic valves, but there was an increasing trend of DOAC-treated patients. Further investigations are needed to confirm the efficacy and safety of DOAC in patients with bioprosthetic valves.
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Izumi et al. (2020) conducted an observational in Atrial fibrillation with bioprosthetic valves (n=214). Antithrombotic therapy was evaluated on Incidence of stroke/systemic embolism. In Japanese AF patients with bioprosthetic valves, antithrombotic therapy resulted in stroke/systemic embolism at 1.77 per 100 person-years and major bleeding at 2.83 per 100 person-years.
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