title: Role of novel anticoagulants for patients with mechanical heart valves.
abstract: The introduction of the target-specific oral anticoagulants (TSOACs) has led to a major shift in the management of patients at risk for thrombosis. The landscape continues to evolve as the evidence regarding their efficacy and safety in various clinical situations emerges. Antithrombotic therapy for thromboprophylaxis in patients with mechanical heart valves is challenging. To date, the RE-ALIGN trial comparing dabigatran etexilate to warfarin is the only randomized controlled study in this patient population. The higher risk of thromboembolic and bleeding events in the group of patients who received dabigatran compared with warfarin reinforced current guidelines recommending against the use of TSOACs in patients with mechanical heart valves. However, additional studies are needed to find suitable alternatives to vitamin K antagonists in this unique patient population.
authors.affiliation: Weill Cornell Medical College, Weill Greenberg Pavilion, 1305 York Avenue, 7th Floor Room 51, New York, NY, 10021, USA, pef9019@nyp.org.
authors.forename: Peter
authors.initials: P
authors.lastname: Forsberg
authors.forename: Maria T
authors.initials: MT
authors.lastname: DeSancho
mesh_terms: D000284:Administration, Oral; D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D006351:Heart Valves / Q000187:drug effects*; D006801:Humans; D013927:Thrombosis / Q000188:drug therapy*
chemical_list: D000925:Anticoagulants