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Xu Z, Wang ZP, Ou JS, et al. Is low anticoagulation intensity more beneficial for patients with bileaflet mechanical mitral valves? a meta-analysis. J Cardiovasc Surg (Torino). 2014;
Xu, Z., Wang, Z. P., Ou, J. S., Yin, S. L., Liu, L. J., & Zhang, X. (2014). Is low anticoagulation intensity more beneficial for patients with bileaflet mechanical mitral valves? a meta-analysis. The Journal of cardiovascular surgery, .
Xu, Z, et al. "Is low anticoagulation intensity more beneficial for patients with bileaflet mechanical mitral valves? a meta-analysis." The Journal of cardiovascular surgery vol. (2014).
Xu Z, Wang ZP, Ou JS, Yin SL, Liu LJ, Zhang X. Is low anticoagulation intensity more beneficial for patients with bileaflet mechanical mitral valves? a meta-analysis. J Cardiovasc Surg (Torino). 2014 Oct 17; Epub 2014 Oct 17. PMID: 25323107.
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J Cardiovasc Surg (Torino). 2014 Oct 17; Epub 2014 Oct 17.

Is low anticoagulation intensity more beneficial for patients with bileaflet mechanical mitral valves? a meta-analysis.

The Journal of cardiovascular surgery

Z Xu, Z P Wang, J S Ou, S L Yin, L J Liu, X Zhang

Affiliations

  1. . Division of Cardiac Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P.R.China - [email protected].

PMID: 25323107

Abstract

AIM: For the mitral valve replacement(MVR) patients using the lowest thrombogenic risk bileaflet valves (St. Jude Medical, Carbomedics and On-X Prosthetic Heart Valve), excellent results can be achieved by adopting the anticoagulation intensity(median INR<2.5)which is lower than the recommended intensity(INR:2.5~3.5). Our aim was to provide a pooled estimate of potential benefit from clinical studies using low anticoagulation intensity and high intensity in these patients.

METHODS: Relevant studies published before Feb. 2014 were searched through a number of digital databases(MEDLINE, EMBASE, Cochrane Library, etc.). They were pooled by SPSS19.0 using the random effect method in three fields: occurrence rate of major thromboembolism, major hemorrhage and major total events.

RESULTS: 14 studies with 3595 patients were included. The follow-up period was 12846.6 patient*year. Pooled estimates indicated reduction in major hemorrhage (RR: 0.420, 95%CI: 0.296~0.595, P<0.001) and major total events(RR: 0.738, 95%CI: 0.604~0.902, P=0.003) in the low intensity group. No difference was noted in major thromboembolism(RR: 1.045, 95%CI: 0.814~1.341, P=0.75).

CONCLUSION: Compared with the recommended high intensity, low anticoagulation intensity (median INR<2.5) may be more beneficial for the MVR patients using the lowest thrombogenic risk bileaflet valves. We recommended an INR between 2.0 and 2.5, with a median INR of 2.3 for these MVR patients.

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