Clinical Characteristics, Procedural Factors, and Outcomes of Percutaneous Coronary Intervention in Patients With Mechanical and Bioprosthetic Heart Valves
| Autor: | Itsik Ben-Dor, Petros Okubagzi, Kyle Buchanan, William S. Weintraub, Vinod H. Thourani, Toby Rogers, Deepakraj Gajanana, Lowell F. Satler, Micaela Iantorno, Ron Waksman, Augusto D. Pichard, Rebecca Torguson |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Vitamin K medicine.medical_treatment Hemorrhage 030204 cardiovascular system & hematology 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Pharmacotherapy Internal medicine medicine Humans In patient cardiovascular diseases 030212 general & internal medicine Aged Retrospective Studies Bioprosthesis Prosthetic valve Aspirin business.industry Anticoagulants Percutaneous coronary intervention Retrospective cohort study Clopidogrel Heart Valve Prosthesis Conventional PCI Cardiology Drug Therapy Combination Female Stents Warfarin Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors medicine.drug |
| Zdroj: | The American Journal of Cardiology. 122:1536-1540 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2018.07.026 |
| Popis: | There is scarcity of evidence regarding antiplatelet and anticoagulant therapy in patients with prosthetic valves undergoing percutaneous coronary intervention (PCI). Our goal was to compare clinical outcomes between patients with mechanical or bioprosthetic valves undergoing PCI. The study population comprised patients with either a bioprosthetic or mechanical heart valve in the aortic and/or mitral position undergoing PCI between January 2003 and July 2017. Demographics, admission, and discharge medications as well as procedural details were documented. Outcomes were postprocedural bleeding, length of stay, and in-hospital deaths. Of 211 patients, we identified 119 and 92 patients with a bioprosthetic or mechanical valve, respectively. Mean age was 75 ± 9 years and 66 ± 12 years in bioprosthetic and mechanical valve patients, respectively. Bare-metal stents were used in 18.2% and 30.1% of bioprosthetic and mechanical valve patients, respectively. Major bleeding was documented in 0.8% and 6.5% of bioprosthetic and mechanical valve patients, respectively (p = 0.04). Use of triple therapy (aspirin AND clopidogrel AND oral vitamin K antagonist) was significantly lower in bioprosthetic valve patients compared with mechanical valve patients (12% vs 68%, p0.001). Our study shows variation in periprocedural anticoagulation and/or antiplatelet choice exists in this population. Patients with mechanical valves experienced higher rates of major bleeding compared with patients with bioprosthetic valves, which could be due to concomitant anticoagulation and dual antiplatelet therapy. |
| Databáze: | OpenAIRE |
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