Antithrombotic therapy in patients with heart valve prostheses.
Heart valve prostheses carry a risk for thrombosis and require an antithrombotic strategy to prevent stroke, systemic embolism, and prosthetic valve thrombosis. Contemporary randomized trials to guide the clinician on the optimal anticoagulant treatment are scarce, and the validity of the historical data for current recommendations can be questioned in view of the changes in valve prostheses, the patient population, and antithrombotic therapies. This limited evidence from clinical trials translates into divergent recommendations from the different scientific societies on the optimal intensity of oral anticoagulation and on the indication for antiplatelet therapy. The availability of new antithrombotic agents and the unclear thrombotic risk of the currently used prostheses underscore the need to redefine antithrombotic treatment in patients with heart valve prostheses.
Department of Cardiovascular Medicine, University of Leuven, Belgium.
Hadewich
H
Hermans
Thomas
T
Vanassche
Paul
P
Herijgers
Bart
B
Meuris
Marie-Christine
MC
Herregods
Frans
F
Van de Werf
Peter
P
Verhamme
D001281:Atrial Fibrillation / Q000150:complications; D003324:Coronary Artery Disease / Q000150:complications; D004359:Drug Therapy, Combination; D004617:Embolism / Q000517:prevention & control; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006083:Graft Occlusion, Vascular / Q000517:prevention & control; D006349:Heart Valve Diseases / Q000209:etiology / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D020521:Stroke / Q000517:prevention & control; D013927:Thrombosis / Q000517:prevention & control; D014812:Vitamin K / Q000037:antagonists & inhibitors
D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D014812:Vitamin K