PMID- 32093747
OWN - NLM
STAT- MEDLINE
DCOM- 20200916
LR  - 20200916
IS  - 1749-8090 (Electronic)
IS  - 1749-8090 (Linking)
VI  - 15
IP  - 1
DP  - 2020 Feb 24
TI  - Comparison of different bridging anticoagulation therapies used after mechanical 
      heart valve replacement in Chinese patients - a prospective cohort study.
PG  - 40
LID - 10.1186/s13019-020-1084-7 [doi]
LID - 40
AB  - OBJECTIVE: To assess different bridging anticoagulation therapies early after 
      mechanical heart valve replacement (MHVR) in Chinese patients. METHODS: We 
      performed a prospective, single-center, observational cohort study of 305 
      patients who underwent elective MHVR with different bridging anticoagulation 
      regimens. Patients enrolled in the study were divided into three bridging therapy 
      groups: the unfractionated heparin (UFH) group (n = 109), the 
      low-molecular-weight heparin (LMWH) group (n = 97), and the UFH with sequential 
      LMWH (UFH-LMWH) group (n = 99). All patients were followed for 4 weeks. RESULTS: 
      Two patients experienced thromboembolic stroke events in the UFH group. The LMWH 
      group was associated with an increase in the incidence of bleeding events 
      compared with the UFH group (10.3% VS 2.8%; P = 0.03). With a comparison of LMWH 
      and UFH group in secondary endpoints, the statistical test for significance 
      indicated a trend of reduced ICU length of stay (P = 0.08), postoperative length 
      of stay (P = 0.08) and time of achieving target INR (P = 0.06). The creatinine 
      level (odds ratio = 1.03; 95% confidence interval = 1.01 to 1.05; P = 0.02) and 
      hypertension (odds ratio = 3.72; 95% confidence interval = 1.35 to 10.28; 
      P = 0.01) were risk factors for bleeding events. CONCLUSION: For Chinese 
      patients, the LMWH bridging anticoagulation presents the increased the incidence 
      of bleeding events, but enables patients to benefit from achieving an early 
      anticoagulation effect. Close follow-up and personalized management are required 
      in patients with thromboembolic and bleeding risk factors. TRIAL REGISTRATION: 
      Chinese Clinical Trial Registry ChiCTR1800019841. Registered 2 December 2018 
      retrospectively.
FAU - Li, Bo-Xia
AU  - Li BX
AD  - Department of Pharmacy, First Hospital of Lanzhou University, Lanzhou, 730000, 
      China.
FAU - Liu, Shi-Dong
AU  - Liu SD
AD  - First Clinical Medical College, Lanzhou University, Lanzhou, 730000, China.
AD  - Cardiovascular Surgery, First Hospital of Lanzhou University, Lanzhou, 730000, 
      China.
FAU - Qi, Liang
AU  - Qi L
AD  - Cardiovascular Surgery, First Hospital of Lanzhou University, Lanzhou, 730000, 
      China.
FAU - Sun, Shusen
AU  - Sun S
AD  - College of Pharmacy and Health Sciences, Western New England University, 
      Springfield, MA, 01119, USA.
FAU - Sun, Wei
AU  - Sun W
AD  - Cardiovascular Surgery, First Hospital of Lanzhou University, Lanzhou, 730000, 
      China.
FAU - Li, Yuan-Min
AU  - Li YM
AD  - Cardiovascular Surgery, First Hospital of Lanzhou University, Lanzhou, 730000, 
      China.
FAU - Song, Bing
AU  - Song B
AUID- ORCID: 0000-0003-0138-2402
AD  - Cardiovascular Surgery, First Hospital of Lanzhou University, Lanzhou, 730000, 
      China. songbinldyy@163.com.
FAU - Wu, Xin-An
AU  - Wu XA
AD  - Department of Pharmacy, First Hospital of Lanzhou University, Lanzhou, 730000, 
      China. xinanwu6511@163.com.
LA  - eng
GR  - 1506RJYA264/Science Foundation for Young Scientists of Gansu province/
GR  - LCYX-Q030/320.6750.19090-40/Scientific Research Foundation of Clinical Pharmacy 
      Branch of Chinese Medical Association-Wu Jieping Medical Foundation/
GR  - ldyyyn2018-03/Hospital Funds of First Hospital of Lanzhou University/
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
DEP - 20200224
PL  - England
TA  - J Cardiothorac Surg
JT  - Journal of cardiothoracic surgery
JID - 101265113
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adult
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - China
MH  - Creatinine/blood
MH  - Drug Therapy, Combination
MH  - Elective Surgical Procedures/adverse effects
MH  - Female
MH  - Heart Valve Prosthesis
MH  - Heart Valve Prosthesis Implantation/*adverse effects
MH  - Heart Valves/*surgery
MH  - Hemorrhage/*chemically induced
MH  - Heparin/adverse effects/*therapeutic use
MH  - Heparin, Low-Molecular-Weight/therapeutic use
MH  - Humans
MH  - Hypertension/complications
MH  - Intensive Care Units
MH  - International Normalized Ratio
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Postoperative Period
MH  - Prospective Studies
MH  - Risk Factors
MH  - Stroke/etiology
MH  - Thromboembolism/complications/*prevention & control
PMC - PMC7041259
OTO - NOTNLM
OT  - Bridging anticoagulation
OT  - Chinese patients
OT  - Low-molecular-weight heparin
OT  - Mechanical heart valve replacement
COIS- The authors declare that they have no competing interests.
EDAT- 2020/02/26 06:00
MHDA- 2020/09/17 06:00
PMCR- 2020/02/24
CRDT- 2020/02/26 06:00
PHST- 2019/07/04 00:00 [received]
PHST- 2020/02/17 00:00 [accepted]
PHST- 2020/02/26 06:00 [entrez]
PHST- 2020/02/26 06:00 [pubmed]
PHST- 2020/09/17 06:00 [medline]
PHST- 2020/02/24 00:00 [pmc-release]
AID - 10.1186/s13019-020-1084-7 [pii]
AID - 1084 [pii]
AID - 10.1186/s13019-020-1084-7 [doi]
PST - epublish
SO  - J Cardiothorac Surg. 2020 Feb 24;15(1):40. doi: 10.1186/s13019-020-1084-7.