Back to Search
Start Over
Rivaroxaban in patients with mechanical heart valves: A pilot study
- Source :
- Thrombosis research. 186
- Publication Year :
- 2019
-
Abstract
- Background Patients with mechanical heart valves are still not eligible for treatment with direct oral anticoagulants (DOAC). We aimed to conduct a proof-of-principle study investigating the anti-Xa inhibitor rivaroxaban as antithrombotic treatment in patients with recent mechanical aortic valve replacement. Materials and methods Low-risk patients scheduled for elective mechanical aortic valve replacement were treated with rivaroxaban 20 mg once daily (OD) in a prospective cohort study, started on day 3 postoperatively and given for 6 months. The study was registered at ClinicalTrials.gov (# NCT02128841 ). Results Ten patients were included (median age, 48; range 39 to 60). Indication was aortic valve stenosis in 6 patients, aortic root aneurysm with severe aortic valve regurgitation in 3 patients, and mixed stenosis/regurgitation in 1 patient. Neither thromboembolic nor bleeding events were observed, and no patient died. Absence of valve thrombosis was demonstrated in all patients. On day 7, median D-dimers were 2723 μg/L (inter-quartile range [IQR] 1672, 5695 μg/L), median TAT levels were 4.5 μg/L (IQR 4.1, 5.6 μg/L); and median peak thrombin generation was 150 nM (IQR 91, 183). On day 90, median D-dimers were 426 μg/L (IQR 278, 569), median TAT levels were 2.7 μg/L (IQR 2.2, 3.1), and median peak thrombin generation were 66 nM (IQR 62, 87). Conclusions Rivaroxaban 20 mg OD was safe and effective in a pilot study of 10 low risk patients with mechanical aortic heart valve. Our results justify larger studies investigating the application of anti-Xa inhibitors in patients with mechanical heart valves.
- Subjects :
- medicine.medical_specialty
Pilot Projects
Regurgitation (circulation)
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Rivaroxaban
Medicine
Humans
Heart valve
Prospective Studies
Prospective cohort study
610 Medicine & health
Aortic valve regurgitation
Heart Valve Prosthesis Implantation
business.industry
Mechanical Aortic Valve
Anticoagulants
Hematology
Middle Aged
medicine.disease
Surgery
Stenosis
medicine.anatomical_structure
030220 oncology & carcinogenesis
Aortic valve stenosis
Aortic Valve
Heart Valve Prosthesis
business
medicine.drug
Factor Xa Inhibitors
Subjects
Details
- ISSN :
- 18792472
- Volume :
- 186
- Database :
- OpenAIRE
- Journal :
- Thrombosis research
- Accession number :
- edsair.doi.dedup.....a586f528a5adc873bb582011fdcaf226