How Did We Get Here?: A Historical Review and Critical Analysis of Anticoagulation Therapy Following Mechanical Valve Replacement

Review

关键词: INTERNATIONAL NORMALIZED RATIO;    VALVULAR HEART-DISEASE;    ATRIAL-FIBRILLATION;    BLEEDING COMPLICATIONS;    ANTITHROMBOTIC THERAPY;    WARFARIN;    INTENSITY;    ADHERENCE;    PREVENTION;    DABIGATRAN;   

DOI  :  10.1161/CIRCULATIONAHA.119.041105

来源: SCIE

【 摘 要 】

Managing severe valvular heart disease with mechanical valve replacement necessitates lifelong anticoagulation with a vitamin K antagonist. Optimal anticoagulation intensity for patients with mechanical valves remains uncertain; current recommendations are inconsistent across guideline bodies and largely based on expert opinion. In this review, we outline the history of anticoagulation therapy in patients with mechanical heart valves and critically evaluate current antithrombotic guidelines for these patients. We conclude that randomized trials evaluating optimal anticoagulation intensity in patients with mechanical valves are needed, and that future guidelines must better justify antithrombotic treatment recommendations.

【 授权许可】

Free