Valvular & structural heart disease
Comparison of Direct Oral Anticoagulants vs Vitamin K Antagonists After Transcatheter Mitral Valve Replacement
Main finding · BleedingResult — go to the resultAdjusted hazard ratio 0.21 95% CI 0.06–0.74Authors' conclusion
The use of DOACs after TMVR, compared with VKAs, appears to reduce the risk of bleeding complications and decrease the length of hospital stay for patients, without a significant increase in the risk of thrombotic events.
Study context
- Population
- Consecutive patients undergoing transseptal transcatheter mitral valve replacement (TMVR) with a SAPIEN family prosthesis, 2011–202320.5% DOAC, 79.5% VKA
- Participants
- 156 patients
- Exposure
- Direct oral anticoagulants (DOACs) vs vitamin K antagonists (VKAs) after transseptal TMVR
- Outcome
- Bleeding
- Follow-up
- Median 4.7 months (Q1-Q3: 2.6-6.7 months)
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
Adjusted hazard ratio
0.21
95% CI 0.06–0.74
P = 0.02
Events by group
DOAC vs VKA
adjusted HR 0.21 (95% CI 0.06–0.74); P = 0.02
Observational data: associations, not effects.
Further findings
Length of hospital stay
- DOAC associated with shorter length of hospital stay
Thrombotic events, major vascular complications, stroke, death
- No significant differences
Original publication
Comparison of Direct Oral Anticoagulants vs Vitamin K Antagonists After Transcatheter Mitral Valve Replacement. J Am Coll Cardiol. Published 16 January 2024. doi:10.
Summarised from the published abstract; every number is checked against it