Valvular & structural heart diseaseCohort study
Comparison of Direct Oral Anticoagulants vs Vitamin K Antagonists After Transcatheter Mitral Valve Replacement
- Prospective cohort study
- single-centre
- consecutive patients
Authors' 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)
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:10.1016/j.jacc.2023.10.031
Summarised from the published abstract; every number is checked against it