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July 13, 2023Gaceta Médica de MéxicoOpen Access

Thromboembolic and hemorrhagic complications in patients with prosthetic heart valves at third level care center. What have we learned?

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Why the study?

Heart valve replacement with mechanical or biological prostheses entails risk of thromboembolism and bleeding complications, prompting an evaluation of complications related to anticoagulation therapy and the probability of risk.

What is the rate of thromboembolic and hemorrhagic complications in patients with prosthetic heart valves receiving vitamin K antagonists?

Comparison

Optimal vs non-optimal INR

Design

Observational cohort study

Authors

FSFernando F. Sánchez-MedinaOVOlivia ValenzuelaLVLucía C. Valenzuela-Molina

Discussion

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Member takes

Overview

Complications linked to non-optimal INR call for vigilant management; leaves open optimal strategies for future trials.

Structured PICO

What is the rate of thromboembolic and hemorrhagic complications in patients with prosthetic heart valves receiving vitamin K antagonists?

P
Population
163 patients who underwent heart valve replacement between 2002 and 2016 with either mechanical or biological prostheses, and who received vitamin K antagonists after hospital discharge. Patients with comorbidities and other risk factors for thrombosis and/or bleeding were excluded.
I
Intervention
Vitamin K antagonists (assessed as optimal vs non-optimal INR) in patients with mechanical or biological heart valve prostheses
O
Outcome
Thromboembolic and hemorrhagic complicationssafety

Patients with mechanical heart valves receiving vitamin K antagonists have a high rate of bleeding and thromboembolic complications, which are strongly associated with non-optimal INR control.

Cite This Study

Sánchez-Medina et al. (2023) studied this question.

synapsesocial.com/papers/6a7d2c08da72e8de9c279188https://doi.org/10.24875/gmm.m23000772
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations2006 · 479 citations
  2. 2Outpatient management of heart valve disease following the COVID-19 pandemic: implications for present and future care2020 · 14 citations
  3. 3Linee guida per il trattamento delle valvulopatie (versione 2012). Task Force congiunta per il Trattamento delle Valvulopatie della Società Europea di Cardiologia (ESC) e dell’Associazione Europea di Chirurgia Cardiotoracica (EACTS)2013 · 390 citations
  4. 4The effects of a low international normalized ratio on thromboembolic and bleeding complications in patients with mechanical mitral valve replacement2014 · 10 citations
  5. 5Re-operation for bioprosthetic aortic structural failure – risk assessment2003 · 110 citations