European Heart Journal Advance Access originally published online on September 22, 2007
European Heart Journal 2007 28(20):2424-2426; doi:10.1093/eurheartj/ehm405
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2007. For permissions please email: journals.permissions@oxfordjournals.org
Improving the quality of anticoagulant therapy in patients with mechanical heart valves: what are we waiting for?
1 Department of Cardiac Surgery, K.U. Leuven, B-3000 Leuven, Belgium
2 Center for Molecular and Vascular Biology, K.U. Leuven, B-3000 Leuven, Belgium
* Corresponding author. Tel: +32 16 344260; fax: +32 16 344616. E-mail address: paul.herijgers@med.kuleuven.be
This editorial refers to Low-dose oral anticoagulation in patients with mechanical heart valve prostheses: final report from the early self-management anticoagulation trial II by H. Koertke et al., on page 2479
Footnotes
The opinions expressed in this article are not necessarily those of the Editors of the European Heart Journal or of the European Society of Cardiology.
| The first 10% of the full text of this article appears below. |
The replacement of destroyed heart valves by mechanical, thrombogenic prostheses would be hard to imagine without the availability of anticoagulant treatment. Coumarins were introduced in clinical practice during and shortly after the Second World War, in the same era that heart valve replacement surgery was pioneered. Still today, vitamin K antagonists are the only available oral anticoagulants for chronic use in patients with mechanical heart valves. Has no progress been made in this field over the past 50 years?
Mechanical heart valves and anticoagulation
Thromboembolic complications and bleedings comprise up to 75% of all complications after mechanical heart valve surgery and predominantly occur in the first year after surgery. For obvious reasons, well-controlled data on the incidence of thromboembolism in the absence of anticoagulation
Coumarins
Self-monitoring and self-management to improve the quality of anticoagulation
Unresolved issues and call for action
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- Low-dose oral anticoagulation in patients with mechanical heart valve prostheses: final report from the early self-management anticoagulation trial II
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EHJ 2007 28: 2479-2484.[Abstract] [FREE Full Text]