Mechanical prosthetic heart valves: Quality of anticoagulation and thromboembolic risk. The observational multicenter PLECTRUM study.

@article{Poli2018MechanicalPH,
  title={Mechanical prosthetic heart valves: Quality of anticoagulation and thromboembolic risk. The observational multicenter PLECTRUM study.},
  author={Daniela Poli and Emilia Antonucci and Vittorio Pengo and Ludovica Migliaccio and Sophie Testa and Corrado Lodigiani and Nadia Coffetti and Roberto Facchinetti and Giuseppina Serricchio and Pietro Falco and Catello Mangione and Serena Masottini and Lucia A. Ruocco and Raffaele de Caterina and Gualtiero Palareti},
  journal={International journal of cardiology},
  year={2018},
  volume={267},
  pages={
          68-73
        }
}
Major bleedings in mechanical prosthetic heart valves patients on Vitamin K antagonist treatment. Data from the PLECTRUM Study
TLDR
MHV patients treated with VKAs followed by Anticoagulation Clinics, showed a low bleeding risk, and the history of previous bleeding, the presence of POAD or of AF, and a TTR in the lowest quartile, were significantly associated with MB.
Association of Antiplatelet and Anticoagulant Treatment in Patients with Mechanical Prosthetic Heart Valves. Data from the Observational Multicentre PLECTRUM Study
TLDR
VKA +apl did not reduce the stroke risk of these patients and is associated with a trend to an increased bleeding risk, which is limited to patients with concomitant arterial disease or at high cardiovascular risk.
Management of Life-Threatening Bleeding in Patients With Mechanical Heart Valves
TLDR
The present literature for the management of bleeding in patients with mechanical heart valves and the safe duration for holding off anticoagulation with minimal risk of valve thrombosis/thromboembolism are reviewed.
Predicting development of thromboembolic complications and complications in patients after mitral valve replacement with mechanical prostheses
The aim of the study. To develop a mathematical model for predicting the development of thromboembolic complications and bleeding in patients after mitral valve replacement with mechanical prostheses
Predictors of Optimum AntiCoagulation in a Mechanical Heart Valve Replacement Population
TLDR
In patients with MHV, a higher INR target, despite more INR determinations, is predictive of suboptimum anti-coagulation, independent of comorbidities.
Bleeding and mortality risk in patients implanted with mechanical prosthetic heart valves with and without thrombocytopenia. Insights from the nationwide PLECTRUM registry.
TLDR
In MPHV patients, thrombocytopenia is associated with an increased risk of death and MB, and there is a growing need for a sex- and age-specific threshold to define platelet count in adult patients.
Comparison of Anticoagulation Quality between Acenocoumarol and Warfarin in Patients with Mechanical Prosthetic Heart Valves: Insights from the Nationwide PLECTRUM Study
  • D. Menichelli, D. Poli, The Italian Federation Of Anticoagulation Clinics
  • Medicine
    Molecules
  • 2021
TLDR
Anticoagulation quality was consistently lower in MPHV patients on acenocoumarol compared to those on warfarin and in all subgroups of patients analyzed according to sex, hypertension, diabetes, age, valve site, atrial fibrillation, and INR range.
Determinants of low‐quality warfarin anticoagulation in patients with mechanical prosthetic heart valves. The nationwide PLECTRUM study
TLDR
TiTR is substantially suboptimal in MPHV patients, particularly in higher INR ranges, as well as in higher normalised ratio ranges.
Sex‐based difference in anticoagulated patients with mechanical prosthetic heart valves and long‐term mortality risk
Vitamin K antagonists (VKAs) reduce thromboembolism in patients with mechanical prosthetic heart valves (MPHV). It is unclear whether a sex‐based difference in MPHV patients regarding valve site,
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References

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Thromboembolic and Bleeding Complications in Patients With Mechanical Heart Valve Prostheses
TLDR
The incidence of bleeding became significantly higher with the addition of antiplatelet therapy, although this did not decrease the risk of thromboembolism any further.
Optimal oral anticoagulant therapy in patients with mechanical heart valves.
TLDR
The intensity of anticoagulant therapy for patients with prosthetic heart valves is optimal when the INR is between 2.5 and 4.9, and the level at which thromboembolic complications are effectively prevented without excessive bleeding is recommended.
Better anticoagulation control improves survival after valve replacement.
TLDR
High anticoagulation variability is the most important independent predictor of reduced survival after valve replacement with a mechanical valve, and better antICOagulation control should improve survival.
Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations
TLDR
The purpose of this article is to review the physiopathology, diagnosis and treatment of PVT and to provide recommendations for management.
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