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The benefit of longevity with a mechanical aortic valve replacement (AVR) needs to be carefully balanced with the risk for bleeding from long-term anticoagulation with vitamin K antagonists (VKAs). Some data suggest that low socioeconomic status may be a barrier to safely using VKAs in this setting.
Using Swedish national registry data, researchers examined the relationship between household income level and risk for adverse VKA-anticoagulation–related outcomes in nearly 6000 patients who underwent mechanical AVR from 1997 to 2018. Patients were on average 56 years old, and about one quarter were women.
After an average follow-up of 20 years, there was a graded inverse association between income quartile and risk for hospitalization for a ble…