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[Evaluation of the antithrombotic strategy in low thrombotic risk patients who underwent aortic valve replacement

Eduardo Aceves-Velázquez1, Gerardo Vieyra-Herrera2, Laura Rodríguez-Chávez2

  • 1Cardiología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México.

Archivos De Cardiologia De Mexico
|July 20, 2017
PubMed

Insights

For patients with low thrombotic risk after bioprosthetic aortic valve replacement, aspirin monotherapy appears safe and effective, avoiding the need for vitamin K antagonists (VKA) during the initial 3 months post-surgery.

Area of Science:

  • Cardiovascular Surgery
  • Cardiology
  • Pharmacology

Background:

  • Anticoagulation after bioprosthetic aortic valve replacement (AVR) in low-risk patients remains controversial.
  • Current guidelines suggest low-dose aspirin as a viable alternative to vitamin K antagonists (VKA).
  • Evidence comparing aspirin monotherapy to VKA in this specific patient population is limited.

Purpose of the Study:

  • To compare the incidence of thrombotic and hemorrhagic complications between different anticoagulation strategies post-bioprosthetic AVR.
  • To evaluate the safety and efficacy of aspirin monotherapy versus VKA in low thrombotic risk patients.
  • To test the hypothesis that aspirin monotherapy offers a beneficial effect compared to VKA.

Main Methods:

  • Retrospective study of 231 low thrombotic risk patients undergoing bioprosthetic AVR from 2011-2015.
  • Patients were divided into three groups: aspirin only, VKA only, and VKA plus aspirin.
  • Follow-up was conducted for 12 months, documenting thrombotic and hemorrhagic complications.

Main Results:

  • No thrombotic complications were observed in any of the study groups.
  • Only one hemorrhagic complication occurred, in the VKA only group.
  • Patients on aspirin monotherapy showed no thrombotic or hemorrhagic events during the 12-month follow-up.

Conclusions:

  • Aspirin monotherapy appears to be a safe and effective strategy for anticoagulation in the first 3 months post-bioprosthetic AVR in low thrombotic risk patients.
  • This approach may negate the need for vitamin K antagonists (VKA) during this critical period.
  • Further prospective studies are warranted to confirm these findings.

Keywords:
Antagonista de vitamina KAnticoagulaciónAnticoagulationAortic valve replacementAspirinAspirinaBioprosthesisCambio valvular aórticoMexicoMéxicoPrótesis biológicaTrombosis valvularValvular thrombosisVitamina K antagonist

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