Rivaroxaban in patients with mechanical heart valves: A pilot study.

Détails

ID Serval
serval:BIB_C8A055AD9C57
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Rivaroxaban in patients with mechanical heart valves: A pilot study.
Périodique
Thrombosis research
Auteur(s)
Roost E., Weber A., Alberio L., Englberger L., Reineke D., Keller D., Nagler M., Carrel T.
ISSN
1879-2472 (Electronic)
ISSN-L
0049-3848
Statut éditorial
Publié
Date de publication
02/2020
Peer-reviewed
Oui
Volume
186
Pages
1-6
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
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.
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).
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).
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.
Mots-clé
Blood coagulation/drug effects, Heart valve prosthesis, Rivaroxaban/therapeutic use, Thromboembolism
Pubmed
Web of science
Création de la notice
20/12/2019 12:26
Dernière modification de la notice
19/11/2020 7:26
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