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Anticoagulation and Antiplatelet Strategies After On-X Mechanical Aortic Valve Replacement

Sunday, June 17, 2018

Submitted by

Tom C. Nguyen

Source

Source Name: Journal of the American College of Cardiology

Source URL: https://doi.org/10.1016/j.jacc.2018.03.535

Author(s)

John D. Puskas, Marc Gerdisch, Dennis Nichols, Lilibeth Fermin, Birger Rhenman, Divya Kapoor, Jack Copeland, Reed Quinn, G. Chad Hughes, Hormoz Azar, Michael McGrath, Michael Wait, Bobby Kong, Tomas Martin, E. Charles Douville, Steven Meyer, Jian Ye, W.R. Eric Jamieson, Lance Landvater, Robert Hagberg, Timothy Trotter, John Armitage, Jeffrey Askew, Kevin Accola, Paul Levy, David Duncan, Bobby Yanagawa, John Ely, Allen Graeve, for the PROACT Investigators

Controversial and revisited topic of dual-antiplatelet therapy (DAPT) (aspirin and clopidogrel) versus low dose warfarin after On-X mechanical aortic valve replacement. There were two arms to the study: low and high risk for thromboembolism. The low-risk arm was terminated secondary to higher thromboembolic events in the DAPT group. For the high-risk groups, patients receiving low dose warfarin with an international normalized ratio goal of 1.5 to 2.0 experienced no difference in mortality or thromboembolic complications compared to the standard dose warfarin group.