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

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 ri...

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Bibliographic Details
Published in:Netherlands heart journal 2015-02, Vol.23 (2), p.111-115
Main Authors: Swinkels, B. M., de Mol, B. A., Kelder, J. C., Vermeulen, F. E., ten Berg, J. M.
Format: Article
Language:English
Subjects:
Age
Aortic stenosis
Blood transfusions
Cardiac arrhythmia
Cardiology
Diabetes
Hypotheses
Hypothesis testing
Medical Education
Medicine
Medicine & Public Health
Mortality
Older people
Original
Original Article
Patients
Prostheses
Stroke
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Summary: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.
ISSN:1568-5888
1876-6250
DOI:10.1007/s12471-014-0626-9