October 2, 1984European Heart Journal
Thromboembolic and haemorrhagic risk in mechanical and biological aortic prostheses
Key result
Aortic bioprostheses linked to ~91% lower hemorrhagic risk vs mechanical valves, with similar thromboembolism rates.
- P<0.005
- n=647
Why the study?
Thromboembolism, valve thrombosis, and haemorrhagic events have been compared between mechanical and biological aortic prostheses to assess their relative risks.
Does the use of aortic bioprostheses compared to mechanical prostheses reduce thromboembolic and haemorrhagic risks in patients undergoing aortic valve replacement?
Comparison
Mechanical aortic prostheses (Starr-Edwards and Björk-Shiley) vs aortic bioprostheses
Design
Cohort study with less than 2% lost to follow-up
Follow-up
Up to 7 years
Authors
Discussion
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Implication
May support bioprostheses to reduce bleeding after AVR; leaves open optimal valve choice pending randomized trials.
Study Design
Type
Cohort (n=647)
Structured PICO
Does the use of aortic bioprostheses compared to mechanical prostheses reduce thromboembolic and haemorrhagic risks in patients undergoing aortic valve replacement?
P
Population
647 patients who received Starr-Edwards, Björk-Shiley, or aortic bioprostheses between 1968 and 1982, followed for up to 7 years.
E
Exposure
Aortic bioprostheses (n=178)
C
Comparator
Mechanical aortic prostheses, specifically Starr-Edwards 1260 (n=356) and Björk-Shiley (n=113)
O
Outcome
Thromboembolism, valve thrombosis, and haemorrhagic events at up to 7 yearshard clinical
Main Result
Absolute Event Rate: 0.2% vs 2.33%
p-value: p=<0.005
Aortic bioprostheses are associated with a significantly lower risk of haemorrhage compared to mechanical valves, driven largely by the quality of anticoagulant therapy required for mechanical valves.
Cite This Study
Farah et al. (1984) conducted a cohort in Aortic valve replacement (n=647). Aortic bioprostheses vs. Mechanical valves (Starr-Edwards and Björk-Shiley) was evaluated on Haemorrhagic risk (% patient/year) (p=<0.005). Aortic bioprostheses were associated with a significantly lower haemorrhagic risk compared to mechanical valves (0.2% vs 2.33% per patient-year, P<0.005), with similar thromboembolism rates.