Epub 2018 Apr 11.J Atr Fibrillation. We used Cochran’s Q test, IMeta-analysis for a particular factor is performed using STATA version 14.0 MP. According to the pre-specified selection criteria, we were able to exclude 467 articles based on the title and abstract of those studies. In detail, over a mean follow-up lasting ≈140 days, ischemic or unspecified stroke occurred in 9 patients (5%) in the dabigatran group and in no patients in the warfarin group. We resolved disagreements by meeting with all authors. ).The estimated prevalence of mitral or aortic valvular heart disease is ≈2.5% in the general population of Western countries, and is expected to rise with population aging. Methodist DeBakey cardiovascular journal.
2015;373(21):2015–24.Lefèvre T. Anticoagulation treatment after Transcatheter aortic valve replacement. Raffaele De Caterina, MD, PhD, University Cardiology Division, G. d’Annunzio University, Chieti, Ospedale SS. Not similar to other NOAC, dabigatran acts as a direct thrombin inhibitor. When it comes to ISTH Major Bleeding in subgroup TAVI, no statistical significance were portrayed between two trials (Overall: RR: 0.935; 95% CI: 0.486, 1.801). Surgical sub-group regarding bioprosthetic TAVI were analysed among those studies revealed NOAC had no advantages over the warfarin group. 2018 Sep;107(9):799-806. doi: 10.1007/s00392-018-1247-x. PLoS Med. In our opinion, 1 single trial with a single NOAC does not represent sufficient evidence for dismissing a therapeutic strategy, anticoagulation with NOACs, that has shown better safety and at least similar efficacy as warfarin in the setting of atrial fibrillation and venous thromboembolism,. So, it seems reasonable that in a case such as exposed above (left atrial appendage resection and bioprosthetic repacement or valve repair) NOACs may be useful 2017;69(17):2193–211.Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA, O'Gara PT, Ruiz CE, Skubas NJ, Sorajja P, et al. Herein, we reevaluate this topic to identify the patient profile that has the greatest likelihood of benefit from some of the NOACs, with a focus on factor Xa inhibitors, thus providing some perspectives for basic and translational research.Antithrombotic management of patients with mechanical heart valves (MHVs) continues to be an important medical problem.

2016;102(13):1036–43.Holster IL, Valkhoff VE, Kuipers EJ, Tjwa E: New oral anticoagulants increase risk for gastrointestinal bleeding: a systematic review and meta-analysis. Evaluation of the novel factor Xa inhibitor edoxaban compared with warfarin in patients with atrial fibrillation: design and rationale for the effective aNticoaGulation with factor xA next GEneration in atrial fibrillation-thrombolysis in myocardial infarction study 48 (ENGAGE AF-TIMI 48). Also, the overall results (RR: 0.652; 95% CI: 0.457, 0.930) showed that there was a protective effect of NOACs compared with warfarin in SSEE event. Till now, warfarin remained to be the main anti-coagulant for VHD and valve surgery [No universal consensus has been made regarding the definition of valvular heart diseases until now, though 2014 AHA/ACC/HRS guideline stated the definition of non-valvular diseases as the absence of rheumatic mitral stenosis, mechanical/Bioprosthetic heart valve or mitral valve repair [On the other hand, the choice of valve materials of patients undergoing valve surgery (i.e. Dr De Caterina reports Steering Committee membership and National Coordination for Italy of several studies on NOACs in cardiovascular disease, including APPRAISE-2 (Apixaban for Prevention of Acute Ischemic Events–2), ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation), AVERROES (Apixaban Versus Acetylsalicylic Acid [ASA] to Prevent Stroke in Atrial Fibrillation Patients Who Have Failed or Are Unsuitable for Vitamin K Antagonist Treatment), ENGAGE AF-TIMI 38 (Global Study to Assess the Safety and Effectiveness of Edoxaban (DU-176b) vs Standard Practice of Dosing With Warfarin in Patients With Atrial Fibrillation), Re-DUAL PCI (Randomized Evaluation of Dual Antithrombotic Therapy with Dabigatran versus Triple Therapy with Warfarin in Patients with Nonvalvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention); and fees, honoraria, and research funding from Sanofi-Aventis, Boehringer Ingelheim, Bayer, BMS/Pfizer, Daiichi-Sankyo, Novartis, Merck, and Portola, as well.The opinions expressed in this article are not necessarily those of the editors or of the American Heart Association. 2017;13(2):73–5.Makkar RR, Fontana G, Jilaihawi H, Chakravarty T, Kofoed KF, De Backer O, Asch FM, Ruiz CE, Olsen NT, Trento A, et al. ), and the results look even better with NOAC than with warfarin. We advise physicians choose the agent based on a case to case, individualized analysis of the valvular pathology, functional status of the patient and the socioeconomic status to provide a management plan that is most suitable to the patient.International society on thrombosis and HaemostasisBenjamin EJ, Levy D, Vaziri SM, D'Agostino RB, Belanger AJ, Wolf PA. Although dedicated analyses have been performed only for apixabanAll NOACs are currently contraindicated, and thus share a black-box warning, in all patients with MHVs.The reported rates of prosthetic valve thrombosis are highly variable, and likely underestimate its true incidence because valve imaging is not performed routinely and may have suboptimal quality.International guidelines for the management of valvular heart disease recommend lifelong anticoagulation with VKAs for all patients with MHVs: recommendations are class I, level of evidence A in the latest American Heart Association/American College of Cardiology guidelinesDuring early development of the NOACs, their efficacy in preventing thrombosis on MHVs was evaluated in preclinical studies.