title: Impact of aspirin use in the incidence of thromboembolic events after bioprosthesis replacement in patients with rheumatic disease.
abstract: BACKGROUND
  There is still much debate regarding the kind of antithrombotic therapy in the immediate postoperative period of bioprosthesis replacement (first three months). Thus, the authors consider relevant to determine the contemporary incidence of thromboembolic events in rheumatic patients early after implantation of aortic and mitral bioprosthesis replacement (first 90 days in the post-operative period) and perform a comparison between isolated Aspirin uses versus no-antiplatelet therapy, in this same context.
  
  
  METHODS
  Between the period of January 2010 to July 2012, all consecutive rheumatic patients, with basal sinus rhythm, who performed mitral and aortic valve replacement with bioprosthesis (pericardial bovine), were included in this prospective cohort study, 184 patients in total. The primary endpoint evaluated were the rate of embolic events.
  
  
  RESULTS
  In the first 30 days, there were three cerebral ischemic events among patients treated in Aspirin group (5.2%) compared with two events in patients without Aspirin therapy (1.7%), HR = 3.18; 95% CI 0.5 to 19.6; P=0.33. Between 31 and 90 days postoperatively, no patient had a primary outcome. The embolism-free survival, bleeding events and the overall survival were not statistically significant between the aspirin and no-antiplatelet groups.
  
  
  CONCLUSIONS
  In conclusion, in this prospective cohort of rheumatic patients, we found a low and very rare incidence rate of embolic events during the first 90 days postoperative period in mitral and isolated aortic position, respectively. The use of aspirin did not significantly reduce the rate of thromboembolism.
authors.forename: André Rodrigues
authors.initials: AR
authors.lastname: Durães
authors.forename: Milena Andrade Oliveira
authors.initials: MA
authors.lastname: Durães
authors.forename: Luis Claudio
authors.initials: LC
authors.lastname: Correia
authors.forename: André Mauricio Souza
authors.initials: AM
authors.lastname: Fernandes
authors.forename: Roque
authors.initials: R
authors.lastname: Aras Junior
mesh_terms: D000328:Adult; D001241:Aspirin / Q000627:therapeutic use*; D001705:Bioprosthesis / Q000009:adverse effects*; D002545:Brain Ischemia / Q000453:epidemiology / Q000517:prevention & control; D018572:Disease-Free Survival; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011182:Postoperative Care; D011183:Postoperative Complications; D011446:Prospective Studies; D012214:Rheumatic Heart Disease / Q000601:surgery*; D012307:Risk Factors; D020521:Stroke / Q000517:prevention & control; D013923:Thromboembolism / Q000453:epidemiology* / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin