Login
Search
Search
0 Dates
2026
2025
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
CPC 2025
CPC 2026
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Direct Oral Anticoagulants versus Vitamin K Antagonists for rheumatic mitral stenosis post-bioprosthetic mitral valve replacement
Session:
Sessão de Posters 30 - Intervenções valvulares cirúrgicas e transcateter para além da válvula aórtica
Speaker:
João Pedro Faria
Congress:
CPC 2026
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.4 Valvular Heart Disease – Treatment
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
João Pedro Ferreira Faria; Bárbara Antunes Rocha; Pedro Lança Pereira; Carla Oliveira Ferreira; Filipe Silva Vilela; Mónica Dias; Sofia Fernandes; Inês Conde; Catarina Vieira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Background:</strong><br /> In patients with rheumatic mitral stenosis (RMS) undergoing bioprosthetic mitral valve replacement (MVR), long-term anticoagulation is often indicated. However, evidence regarding the use of direct oral anticoagulants (DOAC) in this specific population is scarce and inconclusive. This study aimed to compare the incidence of major thromboembolic and hemorrhagic events in RMS patients after bioprosthetic MVR treated with vitamin K antagonists (VKA) versus DOAC.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Methods:</strong><br /> This retrospective cohort study included all patients followed at a tertiary hospital with RMS who underwent bioprosthetic MVR between January 2003 and December 2024 and had an indication for long term anticoagulation. Demographic, clinical, echocardiographic, laboratory, and outcome data were analyzed using univariate and multivariate logistic regression to identify variables associated with all-cause mortality and major events, defined as ischemic or embolic stroke, intracranial hemorrhage, or severe gastrointestinal bleeding. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Results:</strong><br /> The study included 39 patients (89.7% female; median age 70 years). Before surgery, 89.2% had moderate-to-severe mitral stenosis, and 51.4% had multivalvular disease. After surgery, 71.8% received VKA and 23.2% received DOAC. Over a median follow-up of up to 20 years, 35.9% of patients died, 43.6% were hospitalized, 15.4% experienced thrombotic events, and 12.9% had major hemorrhagic events. No statistically significant differences were observed between VKA and DOAC in the occurrence of major events (p=0.577) or mortality (p=1.000). Left ventricular (LV) systolic dysfunction (p=0.011; OR=29.4) and anemia (p=0.014; OR=18.8) were independent predictors of all-cause mortality. Multivalvular disease (p=0.020) and LV dysfunction (p=0.012) were associated with major events, although not independently.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Conclusions:</strong><br /> In patients with RMS undergoing bioprosthetic MVR, DOAC therapy demonstrated similar safety and efficacy to VKA regarding thromboembolic, hemorrhagic, and mortality outcomes. These findings support the potential use of DOAC as a safe alternative for anticoagulation in RHS patients after bioprosthetic valve replacement. </span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site