Valvular & structural heart disease
Valve thrombosis and antithrombotic therapy after bioprosthetic mitral valve replacement: a systematic review and meta-analysis
Authors' conclusion
bMVT is not uncommon, with numerically higher incidence in transcatheter compared to surgical valves, but the comparison was not statistically significant. VKAs are associated with a lower incidence of bMVT compared to DOACs.
Study context
- Population
- Patients after bioprosthetic mitral valve replacement (surgical mitral valve replacement (SMVR) or transcatheter mitral valve replacement (TMVR)), in the absence of prior or active endocarditis and valve thrombosis47 studies, total follow-up 9541.8 patient-years
- Participants
- 6,170 patients
- Comparison
- Incidence of bioprosthetic mitral valve thrombosis (bMVT) after SMVR and TMVR, and between patients on different antithrombotic regimens
- Outcome
- Overall incidence of bMVT
Methodological detailsrandom-effects models
- Random-effects models
Pooled result
As reported in the abstract
Overall incidence of bMVT per 100-patient-years
5.05 [95% confidence interval (CI) 3.18-8.01, I2 = 82%]
Further pooled results
| Outcome | TMVR | SMVR | VKA | DOAC | aIRR (95% CI) | P value | |
|---|---|---|---|---|---|---|---|
| Subclinicalvs clinically significant bMVT | 4.62 (1.39–15.36) | P = 0.012 | |||||
| bMVT after TMVRvs SMVRIncidence, per 100-patient-years | 7.03 | 0.58 | — not stated in the abstract | — not stated in the abstract | 2.19 (0.72–6.72) | P = 0.170 | |
| bMVT on VKAvs DOACLower incidence with VKA | — not stated in the abstract | — not stated in the abstract | 5.72 | 17.08 | 0.31 (0.13–0.73) | P = 0.007 | |
| 0.050.21520Adjusted incidence rate ratio (log scale) |
— not stated in the abstract
- Subclinical vs clinically significant bMVT: Subclinical bMVT incidence 19.11 per 100-patient-years
- Subclinical vs clinically significant bMVT: Clinically significant bMVT incidence 7.91 per 100-patient-years
Original publication
Valve thrombosis and antithrombotic therapy after bioprosthetic mitral valve replacement: a systematic review and meta-analysis. Eur Heart J Cardiovasc Pharmacother. Published 4 February 2025. doi:10.
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