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Non-vitamin K antagonist oral anticoagulants in atrial fibrillation patients with bioprosthetic valves |
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| Authors: | Jason G Andrade Elena Meseguer Romain Didier Charles Dussault Jeffrey I Weitz |
| Institution: | 1. Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, Canada;2. Electrophysiology Service at the Montreal Heart Institute and the Department of Medicine, Université de Montréal, Montreal, CanadaJason.andrade@vch.ca;4. Department of Neurology, H?pital Bichat-Claude Bernard, Paris, France;5. Department of Cardiology, University of Brest hospital, Service de Cardiologie, H?pital de la Cavale Blanche CHRU Brest, France;6. Department of Medicine, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Canada;7. Department of Medicine and The Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Canada |
| Abstract: | Introduction: The non-vitamin K antagonist oral anticoagulants (NOACs), which include dabigatran, apixaban, edoxaban and rivaroxaban, are preferred over vitamin K antagonists for stoke prevention in most patients with non-valvular atrial fibrillation. The NOACs are contraindicated in atrial fibrillation patients with rheumatic mitral stenosis or mechanical heart valves. There is evidence that bioprosthetic heart valves are less thrombogenic than mechanical heart valves, but it is unknown whether the risk of thromboembolism in atrial fibrillation patients with bioprosthetic valves differs from that in patients without such valves. Areas covered: The authors present a review of the efficacy and safety evidence surrounding the use of NOACs for stroke prevention in atrial fibrillation patients with bioprosthetic heart valves. Expert commentary: While the data is limited, there is no significant difference in thromboembolic, and bleeding outcomes in patients with AF and bioprosthetic heart valves treated with NOAC therapy. Future studies are required before definitive conclusions can be drawn regarding the safety and efficacy of NOAC therapy in AF patients bioprosthetic heart valves. |
| Keywords: | Atrial fibrillation bioprosthetic heart valves stroke anticoagulation |