Comparison of Anticoagulation Quality between Acenocoumarol and Warfarin in Patients with Mechanical Prosthetic Heart Valves: Insights from the Nationwide PLECTRUM Study

Vitamin K antagonists are indicated for the thromboprophylaxis in patients with mechanical prosthetic heart valves (MPHV). However, it is unclear whether some differences between acenocoumarol and warfarin in terms of anticoagulation quality do exist. We included 2111 MPHV patients included in the n...

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Bibliographic Details
Published in:Molecules (Basel, Switzerland) Switzerland), 2021-03, Vol.26 (5), p.1425
Main Authors: Menichelli, Danilo, Poli, Daniela, Antonucci, Emilia, Cammisotto, Vittoria, Testa, Sophie, Pignatelli, Pasquale, Palareti, Gualtiero, Pastori, Daniele, The Italian Federation Of Anticoagulation Clinics Fcsa
Format: Article
Language:English
Subjects:
acenocoumarol
Acenocoumarol - therapeutic use
Age
Aged
Antagonists
Anticoagulants
Anticoagulants - therapeutic use
anticoagulation
Blood Coagulation - drug effects
Blood pressure
Cardiovascular disease
Confidence intervals
Diabetes
Diabetes mellitus
Female
Fibrillation
Heart failure
Heart Valve Diseases - therapy
Heart Valve Prosthesis - adverse effects
Heart valves
Humans
Hypertension
Male
mechanical valve
Middle Aged
Musical instruments
Patients
Prostheses
Prosthetic valves
Regression analysis
Retrospective Studies
Statistical analysis
Subgroups
Thromboembolism
time in therapeutic range
Venous Thromboembolism - drug therapy
Venous Thromboembolism - etiology
Vitamin K
Warfarin
Warfarin - therapeutic use
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Summary:Vitamin K antagonists are indicated for the thromboprophylaxis in patients with mechanical prosthetic heart valves (MPHV). However, it is unclear whether some differences between acenocoumarol and warfarin in terms of anticoagulation quality do exist. We included 2111 MPHV patients included in the nationwide PLECTRUM registry. We evaluated anticoagulation quality by the time in therapeutic range (TiTR). Factors associated with acenocoumarol use and with low TiTR were investigated by multivariable logistic regression analysis. Mean age was 56.8 ± 12.3 years; 44.6% of patients were women and 395 patients were on acenocoumarol. A multivariable logistic regression analysis showed that patients on acenocoumarol had more comorbidities (i.e., ≥3, odds ratio (OR) 1.443, 95% confidence interval (CI) 1.081-1.927, = 0.013). The mean TiTR was lower in the acenocoumarol than in the warfarin group (56.1 ± 19.2% vs. 61.6 ± 19.4%, < 0.001). A higher prevalence of TiTR (
ISSN:1420-3049
1420-3049
DOI:10.3390/molecules26051425