Warfarin May Be Beneficial for up to 6 Months After Bioprosthetic AVR

Data from a Danish registry supports current recommendations for 3 months of anticoagulation and suggests that extending therapy confers additional benefit.

Bioprosthetic valves now predominate in aortic valve replacement (AVR). The current guideline recommendation of anticoagulation for 3 months after bioprosthetic AVR is controversial and often disregarded for fear of bleeding complications. Furthermore, the potential benefit of extending warfarin treatment beyond 3 months is unknown. Investigators used a Danish national registry including information on hospital admissions and prescription drug use to study outcomes in 4075 patients (mean age, 75; 41% women) who underwent bioprosthetic AVR during 1997–2009, excluding those taking anticoagulants before surgery and those with postoperative atrial fibrillation. Events occurring in the first 30 days after surgery were excluded from the analysis.…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)