Key result
In this baseline analysis of 899 Japanese patients with atrial fibrillation and bioprosthetic valves, 55.0% were treated with warfarin, 29.3% with DOACs, and 9.7% with antiplatelet therapy.
Why the study?
Clinical data on real-world antithrombotic treatment practices and the incidence of thromboembolic and bleeding events in Japanese patients with AF after bioprosthetic valve replacement were needed to bridge the clinical data gap with Western countries.
Observational (n=899)
Yes
In a large Japanese cohort of patients with AF and bioprosthetic valves, warfarin remains the predominant antithrombotic strategy, though DOACs are used in nearly 30% of patients.
Answers are grounded in this paper and cite their sources.
Highlights ongoing warfarin dominance in real-world Japanese AF with bioprosthetic valves; leaves optimal strategy open pending randomized data.
PURPOSE: To date, clinical data on real-world treatment practices in Japanese patients with atrial fibrillation (AF) after bioprosthetic valve (BPV) replacement are needed. We conducted a large-scale, prospective, multicenter study to understand the actual usage of antithrombotic therapy and the incidence of thromboembolic and bleeding events in these patients, and to eliminate the clinical data gap between Japan and Western countries. METHODS: This was an observational study, in patients who had undergone BPV replacement and had a confirmed diagnosis of AF, with no mandated interventions. We report the baseline demographic and clinical data for the 899 evaluable patients at the end of the enrollment period. Many patients (76.2%) had comorbid hypertension and 54.8% had heart failure. Most BPVs (65.5%) were positioned in the aortic valve. Warfarin-based therapy, direct oral anticoagulant (DOAC)-based therapy, and antiplatelet therapy (without warfarin and DOAC) were administered to 55.0%, 29.3%, and 9.7% of patients, respectively. CONCLUSION: Patients enrolled into this study are typical of the wider Japanese AF/BPV population in terms of age and clinical history. Future data accruing from the observational period will contribute to future treatment recommendations and guide therapeutic decisions in patients with BPV and AF. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: UMIN000034485.
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Furukawa et al. (2020) conducted an observational in Atrial fibrillation after bioprosthetic valve replacement (n=899). Antithrombotic therapy was evaluated on Rate of stroke or systemic embolism. In this baseline analysis of 899 Japanese patients with atrial fibrillation and bioprosthetic valves, 55.0% were treated with warfarin, 29.3% with DOACs, and 9.7% with antiplatelet therapy.
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