Abstract
This cohort study assesses direct oral anticoagulant use in patients with surgical prosthetic heart valves in the United States and evaluates differences in preoperative and postoperative profiles in patients discharged while receiving direct oral anticoagulant vs warfarin.
Highlights
In patients with mechanical heart valves, use of direct oral anticoagulants (DOACs) is currently contraindicated, and their use in patients with bioprosthetic heart valves is off-label.[1,2] We sought to determine the current state of use of DOACs in patients with surgical prosthetic heart valves in the US and evaluate differences in preoperative and postoperative profiles among patients discharged while receiving DOACs vs warfarin.Author affiliations and article information are listed at the end of this article
The use of DOACs was observed among 78.6% (858 0f 1092) hospitals and 59.6% (1627 of 2731) physicians captured in the STS database
In patients undergoing aortic valve replacement with bioprosthetic heart valves (n = 116 203), the overall use of DOACs over the study period was 4.66% (5625 of 116 203; 4622 patients received factor Xa inhibitors, and 680 patients received thrombin inhibitors), and the use increased over the study period: 3.30% in 2014, 3.80% in 2015, 5.14% in 2016, and 6.64% in 2017 (P = .02 for trend)
Summary
In patients with mechanical heart valves, use of direct oral anticoagulants (DOACs) is currently contraindicated, and their use in patients with bioprosthetic heart valves is off-label.[1,2] We sought to determine the current state of use of DOACs in patients with surgical prosthetic heart valves in the US and evaluate differences in preoperative and postoperative profiles among patients discharged while receiving DOACs vs warfarin.Author affiliations and article information are listed at the end of this article.
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