HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Warfarin or aspirin in embolism prevention in patients with mitral valvulopathy and atrial fibrillation.

AbstractBACKGROUND:
Atrial fibrillation (AF) associated to rheumatic mitral valve disease (RMVD) increases the incidence of thromboembolism (TE), with warfarin being the standard therapy, in spite of difficulties in treatment adherence and therapeutic control.
OBJECTIVE:
To compare the effectiveness of Aspirin vs Warfarin in TE prevention in patients with AF and RMVD.
METHODS:
A total of 229 patients (pts) with AF and RMVD were followed in a prospective and randomized study. The first group consisted of 110 pts receiving Aspirin - 200 mg/day (Group Aspirin - GA) and the second group consisted of 119 pts receiving Warfarin at individually-adjusted doses (Group Warfarin - GW).
RESULTS:
There were 15 embolic events in GA and 24 in GW (p = 0.187), of which 21 presented INR < 2.0. Thus, after excluding patients with inadequate INR, there was a higher number of embolic events in GA than in GW (15 vs 3) (p < 0.0061). The GW showed lower treatment adherence (p = 0.001). Neither group presented episodes of major bleeding. Small bleeding episodes were more frequent in the GW (p < 0.01). Increased serum levels of cholesterol and triglycerides constituted a risk factor for a higher number of thromboembolic events in the studied population, with no difference between the groups.
CONCLUSION:
In patients presenting RMVD with AF for less than a year and no previous embolism, Aspirin is little effective in preventing TE. Patients with lower-risk mitral valvulopathy (mitral regurgitation and mitral biological prosthesis), especially in cases presenting contraindication to or low adherence to Warfarin, Aspirin use can present some benefit in TE prevention.
AuthorsPaulo de Lara Lavitola, Roney Orismar Sampaio, Walter Amorim de Oliveira, Berta Napchan Bôer, Flavio Tarasoutchi, Guilherme Sobreira Spina, Max Grinberg
JournalArquivos brasileiros de cardiologia (Arq Bras Cardiol) Vol. 95 Issue 6 Pg. 749-55 (Dec 2010) ISSN: 1678-4170 [Electronic] Brazil
PMID20976374 (Publication Type: Journal Article, Randomized Controlled Trial)
Chemical References
  • Anticoagulants
  • Warfarin
  • Aspirin
Topics
  • Aged
  • Anticoagulants (therapeutic use)
  • Aspirin (therapeutic use)
  • Atrial Fibrillation (metabolism)
  • Bioprosthesis
  • Heart Valve Prosthesis
  • Hemorrhage (epidemiology)
  • Humans
  • Male
  • Medication Adherence (statistics & numerical data)
  • Mitral Valve Insufficiency (metabolism, therapy)
  • Prospective Studies
  • Risk Factors
  • Thromboembolism (epidemiology, etiology, prevention & control)
  • Warfarin (therapeutic use)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: