Warfarin plus Aspirin After Aortic Valve Prosthesis Placement?

Patients receiving an aortic bioprosthesis have a low overall risk for thromboembolism, but controversy surrounds whether they benefit from anticoagulation in the first months after surgery. To address this issue, researchers used the Society of Thoracic Surgeons Adult Cardiac Surgery Database to compare the effectiveness of the early use of aspirin alone, aspirin plus warfarin, and warfarin alone.

The sample included 25,656 patients aged ≥65 (median age, 77; 39% women) who received an isolated aortic valve prosthesis at 797 hospitals from 2004 through 2006. At 3 months, the mortality rate was 3.0% in the aspirin-only group, 3.1% in the aspirin-plus-warfarin group, and 4.0% in the warfarin-only group. In the multivariable analysis, the addit…