Can warfarin be replaced by non-vitamin K anticoagulants in prosthetic valves?
Mahmoud Hassan AbdelnabiJuthipong BenjanuwattraAshraf AhmedAbdallah AlmaghrabyPublished in: Expert review of cardiovascular therapy (2022)
Although NOACs have proven to be even safer and more effective alternatives to vitamin K antagonists (VKAs) in several indications for anticoagulation, the data regarding their safety and efficacy in prosthetic heart valves is still debatable. The controversial data regarding NOACs use in prosthetic valves renders it difficult to define specific guideline-recommendation for safe and efficient use in this population. The available evidence suggesting that NOACs are as safe and as efficient as VKA regarding thromboembolic prophylaxis and risk of bleeding was primarily based on patients who had undergone bioprosthetic valve and concomitant atrial fibrillation. Further research is warranted to establish if NOACs can be a safer and more efficient alternative to VKAs in patients with prosthetic valves either metallic or bioprosthetic.
Keyphrases
- oral anticoagulants
- atrial fibrillation
- aortic valve
- aortic valve replacement
- transcatheter aortic valve replacement
- aortic stenosis
- transcatheter aortic valve implantation
- left atrial
- catheter ablation
- left atrial appendage
- direct oral anticoagulants
- heart failure
- electronic health record
- mitral valve
- percutaneous coronary intervention
- big data
- ejection fraction
- machine learning
- venous thromboembolism