- 著者
-
Makoto Miyake
Misa Takegami
Yuki Obayashi
Masashi Amano
Takeshi Kitai
Tomoyuki Fujita
Tadaaki Koyama
Hidekazu Tanaka
Kenji Ando
Tatsuhiko Komiya
Masaki Izumo
Hiroya Kawai
Kiyoyuki Eishi
Kiyoshi Yoshida
Takeshi Kimura
Ryuzo Nawada
Tomohiro Sakamoto
Yoshisato Shibata
Toshihiro Fukui
Kenji Minatoya
Kenichi Tsujita
Yasushi Sakata
Tetsuya Kimura
Kumiko Sugio
Atsushi Takita
Atsushi Iwakura
Toshihiro Tamura
Kunihiro Nishimura
Yutaka Furukawa
Chisato Izumi
for the BPV-AF Registry Group
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-22-0226, (Released:2022-07-08)
- 参考文献数
- 28
- 被引用文献数
-
2
Background: Current guidelines equally recommend direct oral anticoagulants (DOACs) and warfarin for atrial fibrillation (AF) patients with a bioprosthetic valve (BPV); however, there are limited data comparing DOACs and warfarin in AF patients with an aortic BPV.Methods and Results: This post-hoc subgroup analysis of a multicenter, prospective, observational registry (BPV-AF Registry) aimed to compare DOACs and warfarin in AF patients with an aortic BPV. The primary outcome was a composite of stroke, systemic embolism, major bleeding, heart failure requiring hospitalization, all-cause death, or BPV reoperation. The analysis included 479 patients (warfarin group, n=258; DOAC group, n=221). Surgical aortic valve replacement was performed in 74.4% and 36.7% of patients in the warfarin and DOAC groups, respectively. During a mean follow up of 15.5 months, the primary outcome occurred in 45 (17.4%) and 32 (14.5%) patients in the warfarin and DOAC groups, respectively. No significant difference was found in the primary outcome between the 2 groups (adjusted hazard ratio: 0.88, 95% confidence interval: 0.51–1.50). No significant multiplicative interaction was observed between the anticoagulant effects and type of aortic valve procedure (P=0.577).Conclusions: Among AF patients with an aortic BPV, no significant difference was observed in the composite outcome of adverse clinical events between patients treated with warfarin and those treated with DOACs, suggesting that DOACs can be used as alternatives to warfarin in these patients.