LOWERing the INtensity of oral anticoaGulant Therapy in patients with bileaflet mechanical aortic valve replacement: Results from the "lOWERING-IT" Trial

American Heart Journal

Volumn 160, Issue 1, 2010, Pages 171-178

  Torella, Michele ^a   Torella, Daniele ^b,c   Chiodini, Paolo ^a   Franciulli, Marco ^a   Romano, Giampaolo ^a   De Santo, Luca ^d   De Feo, Marisa ^a   Amarelli, Cristiano ^a   Sasso, Ferdinando C ^a   Salvatore, Teresa ^a   Ellison, Georgina M ^c   Indolfi, Ciro ^b   Cotrufo, Maurizio ^a   Nappi, Gianantonio ^a  

^a SECOND UNIVERSITY OF NAPLES   (Italy)

^b UNIVERSITY MAGNA GRAECIA OF CATANZARO   (Italy)

^c LIVERPOOL JOHN MOORES UNIVERSITY   (United Kingdom)

^d UNIVERSITY OF FOGGIA   (Italy)

Author keywords

[No Author keywords available]

Indexed keywords

ENOXAPARIN; WARFARIN;

ADULT; ANTICOAGULANT THERAPY; AORTA VALVE PROSTHESIS; AORTA VALVE REPLACEMENT; ARTICLE; BLEEDING; BRAIN HEMORRHAGE; BRAIN ISCHEMIA; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DRUG FATALITY; DRUG SAFETY; EMBOLISM; EPISTAXIS; FEASIBILITY STUDY; FEMALE; FOLLOW UP; GINGIVA BLEEDING; HEMATEMESIS; HEMATOMA; HEMATURIA; HEMOPERITONEUM; HUMAN; INTERNATIONAL NORMALIZED RATIO; LOW DRUG DOSE; MAJOR CLINICAL STUDY; MALE; PRIORITY JOURNAL; PROSPECTIVE STUDY; PROSTHETIC VALVE THROMBOSIS; RANDOMIZED CONTROLLED TRIAL; RECTUM HEMORRHAGE; SPINAL CORD HEMORRHAGE; STANDARD; THROMBOEMBOLISM; TRANSIENT ISCHEMIC ATTACK; TREATMENT OUTCOME;

ADMINISTRATION, ORAL; ADULT; ANTICOAGULANTS; AORTIC VALVE STENOSIS; DOSE-RESPONSE RELATIONSHIP, DRUG; FEMALE; FOLLOW-UP STUDIES; HEART VALVE PROSTHESIS; HUMANS; INCIDENCE; ITALY; MALE; MIDDLE AGED; POSTOPERATIVE HEMORRHAGE; PROGNOSIS; PROSPECTIVE STUDIES; PROSTHESIS DESIGN; RISK FACTORS; THROMBOSIS; YOUNG ADULT;

EID: 77955705858     PISSN: 00028703     EISSN: 10976744     Source Type: Journal    
DOI: 10.1016/j.ahj.2010.05.005     Document Type: Article

References (28)

1. Alexander R.W., Schlant R., and Fuster V. Hurst's the heart. Arteries and veins McGraw-Hill 52 1998 1704 1708
2. Hirsh J., Fuster V., and AnseIl J. American Heart Association/American College of Cardiology Foundation guide to warfarin therapy Circulation 107 2003 1692 1711
3. Edmunds L.H. Jr Thrombotic and bleeding complications of prosthetic heart valves Ann Thor Surg 44 1987 430 445
4. Vink R., Kraaijenhagen R.A., and Hutten B.A. The optimal intensity of vitamin K antagonists in patients with mechanical heart valves: a meta-analysis J Am Coll Cardiol 42 2003 2042 2048
5. Hering D., Piper C., and Bergemann R. Thromboembolic and bleeding complications following St. Jude Medical valve replacement: results of the German Experience With Low-Intensity Anticoagulation Study Chest 127 2005 53 59
6. Cannegieter S.C., Torn M., and Rosendaal F.R. Oral anticoagulant treatment in patients with mechanical heart valves: how to reduce the risk of thromboembolic and bleeding complications J Intern Med 245 1999 369 374
7. Cannegieter S.C., Rosendaal F.R., and Wintzen A.R. Optimal oral anticoagulant therapy in patients with mechanical heart valves N Engl J Med 333 1995 11 17
8. Horstkotte D., Schulte H., and Bircks W. Unexpected findings concerning thromboembolic complications and anticoagulation after complete 10 year follow up of patients with St. Jude Medical prostheses J Heart Valve Dis 2 1993 291 301
9. Turpie A.G., Gunstensen J., and Hirsh J. Randomized comparison of two intensities of oral anticoagulant therapy after tissue heart valve replacement Lancet 1 1988 1242 1245
10. Saour J.N., Sieck J.O., and Mamo L.A. Trial of different intensities of anticoagulation in patients with prosthetic heart valves N Eng J Med 322 1990 428 432
11. Acar J., Iung B., and Boissel J.P. AREVA: multicenter randomized comparison of low-dose versus standard dose anticoagulation in patients with mechanical prosthetic heart valves Circulation 94 1996 2107 2112
12. Torn M., van der Meer F.J., and Rosendaal F.R. Lowering the intensity of oral anticoagulant therapy: effects on the risk of hemorrhage and thromboembolism Arch Intern Med 164 2004 668 673
13. Butchart E.G., Lewis P.A., and Grunkemeier G.L. Low risk of thrombosis and serious embolic events despite low-intensity anticoagulation: experience with 1,004 Medtronic Hall valves Circulation 78 3 Pt 2 1988 I66 I77
14. Horstkotte D., Schulte H.D., and Bircks W. Lower intensity anticoagulation therapy results in lower complication rates with the St. Jude Medical prosthesis J Thorac Cardiovasc Surg 107 1994 1136 1145
15. Altman R., Rouvier J., and Gurfinkel E. Comparison of two levels of anticoagulant therapy in patients with substitute heart valves J Thorac Cardiovasc Surg 101 1991 427 431
16. Albertal J., Sutton M., and Pereyra D. Experience with moderate intensity anticoagulation and aspirin after mechanical valve replacement: a retrospective, non-randomized study J Heart Valve Dis 2 1993 302 307
17. Bonow R.O., Carabello B.A., and Chatterjee K. Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Valvular Heart Disease) Circulation 118 2008 e523 e661
18. Vahanian A., Baumgartner H., and Bax J. Guidelines on the management of valvular heart disease: the Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J. 28 2007 230 268
19. Salem D.N., O'Gara P.T., and Christopher Madias C. Valvular and Structural Heart Disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition) Chest 133 2008 593S 629S
20. Eikelboom J.W., and Weitz J.I. A replacement for warfarin. The search continues Circulation 116 2007 131 133
21. Koertke H., Zittermann A., and Tenderich G. Low-dose oral anticoagulation in patients with mechanical heart valve prostheses: final report from the early self-management anticoagulation trial II Eur Heart J 28 2007 2479 2484
22. Cappelleri J.C., Fiore L.D., and Brophy M.T. Efficacy and safety of combined anticoagulant and antiplatelet therapy versus anticoagulant monotherapy after mechanical heart-valve replacement: a metaanalysis Am Heart J 130 3 Pt 1 1995 547 552
23. Herijgers P., and Verhamme P. Improving the quality of anticoagulant therapy in patients with mechanical heart valves: what are we waiting for? Eur Heart J 28 2007 2424 2426
24. Halkos M.E., and Puskas J.D. Are all bileaflet mechanical valves equal? Curr Opin Cardiol 24 2009 136 141
25. Williams M.A., and van Riet S. The On-X heart valve: mid-term results in a poorly anticoagulated population J Heart Valve Dis 15 2006 80 86
26. The European Atrial Fibrillation Trial Study Group Optimal oral anticoagulation therapy in patients with non-rheumatic atrial fibrillation and recent cerebral ischemia N Engl J Med 333 1995 5 10
27. Hylek E.M., Skates S.J., and Sheehan M.A. An analysis of the lowest effective intensity of prophylactic anticoagulation for patients with nonrheumatic atrial fibrillation N Engl J Med 335 1996 540 546
28. Hylek E.M., Go A.S., and Chang Y. Effect of intensity of oral anticoagulation on stroke severity and mortality in atrial fibrillation N Engl J Med 349 2003 1019 1026