Key result
Mechanical valves link to higher LDH and lower platelets than bioprostheses, despite similarly elevated platelet proteins.
Why the study?
Do bioprosthetic heart valves cause different levels of hemolysis or platelet activation compared to prosthetic heart valves?
Observational
Do bioprosthetic heart valves cause different levels of hemolysis or platelet activation compared to prosthetic heart valves?
p-value: p=<0.001
Both bioprosthetic and prosthetic heart valves cause platelet damage, but bioprostheses do not cause hemolysis or activation of the coagulation system compared to prosthetic valves.
Both valve types may activate platelets; cross-sectional data leave open whether bioprostheses reduce hemolysis versus mechanical valves.
beta-Thromboglobulin (beta TG), platelet factor 4 (PF4), fibrinopeptide A (FPA), lactic dehydrogenase (LDH), and platelet count were evaluated in patients with bioprostheses and prosthetic heart valves. beta TG and PF4 were significantly elevated in both patient groups (p less than 0.001), whereas FPA was normal. There was no significantly difference in plasma concentrations of beta TG and PF4 between patients with prosthetic heart valves and bioprostheses. LDH levels were significantly (p less than 0.001) higher and platelet count lower (p less than 0.001) in patients with prosthetic cardiac valves. The data indicate that bioprostheses do not cause haemolysis or activation of the coagulation system. The findings that the plasma concentration of platelet-specific proteins were elevated, support the assumption that both types of valves cause platelet damage.
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Dudczak et al. (2009) conducted an observational in Artificial Heart Valves. Prosthetic heart valves vs. Bioprostheses was evaluated on Plasma concentrations of beta-Thromboglobulin, platelet factor 4, fibrinopeptide A, lactic dehydrogenase, and platelet count (p=<0.001). Prosthetic heart valves and bioprostheses both significantly elevated platelet-specific proteins (p<0.001), while prosthetic valves additionally caused higher LDH and lower platelet counts (p<0.001).
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