Key result
Trapidil added to warfarin is associated with ~52% less thromboembolism after heart valve replacement.
Why the study?
Does the addition of trapidil or dipyridamole to warfarin reduce platelet aggregation and prevent thromboembolism in patients with heart valve replacement?
Does the addition of trapidil or dipyridamole to warfarin reduce platelet aggregation and prevent thromboembolism in patients with heart valve replacement?
The addition of antiplatelet drugs such as trapidil or dipyridamole to warfarin safely reduces platelet aggregation and may lower the risk of thromboembolism in patients with prosthetic heart valves.
Answers are grounded in this paper and cite their sources.
Addition of trapidil or dipyridamole to warfarin was associated with lower thromboembolism rates after valve replacement; supports randomized confirmation before practice change.
To evaluate the effect of antithrombotic therapy, serial changes in platelet aggregability were investigated in 103 patients who had received heart valve replacement. All patients received warfarin and were divided into three groups: warfarin alone (control), and combined with trapidil and dipyridamole. Both antithrombogenic drugs were given at a dose of 300 mg/day. Platelet count and aggregation were evaluated out every three months for 36 months.Antiplatelet drugs had no affect on the platelet count during the course. The platelet aggregation did not change in the control group, but were decreased at 24 and 30 months in the trapidil group and 24 months in the dipyridamole group. The platelet aggregation was significantly suppressed by trapidil compared to the control at 30 months. The incidence of thromboembolism in control, trapidil and dipyridamole groups was 9.0%, 4.3% and 7.7% respectively. These results indicate that anti-platelet drugs given with warfarin are safe and effective for patients with a prosthetic valve to prevent thromboembolism.
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Masayoshi KOJO (1990) studied Heart valve replacement (n=103). Trapidil or dipyridamole added to warfarin vs. Warfarin alone was evaluated on Thromboembolism. Trapidil or dipyridamole added to warfarin resulted in thromboembolism rates of 4.3% and 7.7% respectively, compared to 9.0% with warfarin alone after heart valve replacement.
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