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Swinkels BM, de Mol BA, Kelder JC, et al. Long-term bleeding events after mechanical aortic valve replacement in patients under the age of 60. Neth Heart J. 2015;23(2):111-5doi: 10.1007/s12471-014-0626-9.
Swinkels, B. M., de Mol, B. A., Kelder, J. C., Vermeulen, F. E., & Ten Berg, J. M. (2015). Long-term bleeding events after mechanical aortic valve replacement in patients under the age of 60. Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 23(2), 111-5. https://doi.org/10.1007/s12471-014-0626-9
Swinkels, B M, et al. "Long-term bleeding events after mechanical aortic valve replacement in patients under the age of 60." Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation vol. 23,2 (2015): 111-5. doi: https://doi.org/10.1007/s12471-014-0626-9
Swinkels BM, de Mol BA, Kelder JC, Vermeulen FE, Ten Berg JM. Long-term bleeding events after mechanical aortic valve replacement in patients under the age of 60. Neth Heart J. 2015 Feb;23(2):111-5. doi: 10.1007/s12471-014-0626-9. PMID: 25408510; PMCID: PMC4315789.
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Neth Heart J. 2015 Feb;23(2):111-5. doi: 10.1007/s12471-014-0626-9.

Long-term bleeding events after mechanical aortic valve replacement in patients under the age of 60.

Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation

B M Swinkels, B A de Mol, J C Kelder, F E Vermeulen, J M Ten Berg

Affiliations

  1. Department of Cardiology, St. Antonius Hospital, PO Box 2500, 3435, CM, Nieuwegein, the Netherlands, [email protected].

PMID: 25408510 PMCID: PMC4315789 DOI: 10.1007/s12471-014-0626-9

Abstract

BACKGROUND: Although younger patients are supposed to be less susceptible to bleeding complications of mechanical aortic valve replacement (mAVR) than older patients, there is a relative paucity of data on this subject. Therefore, it remains uncertain whether younger patients are really at a lower risk of these complications than older patients.

METHODS: Incidence rates of bleeding events during 15 years of follow-up after mAVR were compared between 163 patients under 60 (group I), 122 patients between 60 and 65 (group II), and 145 patients over 65 (group III) years of age at operation. The target international normalised ratio (INR) was 3.0-4.0.

RESULTS: During 15 years of follow-up, the annual incidence rate of major bleeding events (excluding haemorrhagic stroke) was lower in the youngest as compared with the oldest group (3.0 versus 4.7 %, respectively; p = 0.030). However, the annual incidence rate of haemorrhagic stroke was as high in the youngest as in the two older groups (0.6 versus 0.7 % and 0.7 %, respectively; p = 0.928).

CONCLUSIONS: With a target INR of 3.0-4.0, patients under 60 years of age are at equally high risk of haemorrhagic stroke after mAVR as older patients. This finding confirms the relevance of a lower target INR as used in international guidelines.

References

  1. Circulation. 1996 Nov 1;94(9):2107-12 - PubMed
  2. Circulation. 1998 Nov 3;98(18):1949-84 - PubMed
  3. Stroke. 2000 Nov;31(11):2558-62 - PubMed
  4. Lancet. 1996 Aug 17;348(9025):423-8 - PubMed
  5. Br J Clin Pharmacol. 1977 Jun;4(3):315-20 - PubMed
  6. J Am Coll Cardiol. 2006 Aug 1;48(3):e1-148 - PubMed
  7. Circulation. 2011 May 31;123(21):2363-72 - PubMed
  8. N Engl J Med. 1993 May 6;328(18):1289-96 - PubMed
  9. Eur Heart J. 2007 Oct;28(20):2479-84 - PubMed
  10. Chest. 2010 Nov;138(5):1093-100 - PubMed
  11. N Engl J Med. 1995 Jul 6;333(1):11-7 - PubMed
  12. Ann Thorac Surg. 2003 Jun;75(6):1815-9 - PubMed
  13. Arch Intern Med. 1993 Jul 12;153(13):1557-62 - PubMed
  14. Am J Cardiol. 2012 Aug 1;110(3):453-60 - PubMed
  15. Chest. 2005 Jan;127(1):53-9 - PubMed
  16. Lancet. 2007 Aug 11;370(9586):493-503 - PubMed
  17. Arch Intern Med. 2009 Jul 13;169(13):1203-9 - PubMed
  18. Chest. 2001 Jan;119(1 Suppl):220S-227S - PubMed
  19. Eur Heart J. 2012 Oct;33(19):2451-96 - PubMed
  20. Arch Intern Med. 2004 Mar 22;164(6):668-73 - PubMed
  21. Am J Cardiol. 1998 Mar 15;81(6):736-9 - PubMed
  22. Ned Tijdschr Geneeskd. 2004 Apr 10;148(15):730-5 - PubMed
  23. Ann Thorac Surg. 2008 Apr;85(4):1490-5 - PubMed
  24. Ann Thorac Surg. 2001 Apr;71(4):1172-80 - PubMed

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