Early Anticoagulation of Bioprosthetic Aortic Valves in Older Patients: Results From the Society of Thoracic Surgeons Adult Cardiac Surgery National Database

摘要: Objectives The aim of this study was to evaluate the risks and benefits short-term anticoagulation in patients receiving aortic valve bioprostheses. Background Patients bioprostheses have an elevated early risk thromboembolic events; however, been debated with limited evidence. Methods Our cohort consisted 25,656 ≥65 years age at 797 hospitals within Society Thoracic Surgeons Adult Cardiac Surgery Database (2004 2006). associated 3-month incidences death or readmission for embolic (cerebrovascular accident, transient ischemic attack, noncerebral arterial thromboembolism) bleeding events were compared across discharge strategies propensity methods. Results In (median age, 77 years), 3 most common included: aspirin-only (49%), warfarin-only (12%), warfarin plus aspirin (23%). Among those aspirin-only, adverse low (death, 3.0%; events, 1.0%; 1.0%). Relative treated had a lower adjusted (relative [RR]: 0.80, 95% confidence interval [CI]: 0.66 0.96) event (RR: 0.52, CI: 0.35 0.76) but higher 2.80, 2.18 3.60). similar 1.01, 0.80 1.27), 0.95, 0.61 1.47), 1.23, 0.85 1.79). These results generally consistent patient subgroups. Conclusions Death relatively rare first months after bioprosthetic replacement. Compared reduced cost increased risk.