Sex‐based difference in anticoagulated patients with mechanical prosthetic heart valves and long‐term mortality risk

• DOI: 10.1111/ijcp.14064
• Publication Date: 2021-02-06T01:26:52Z
• Authors: Daniele Pastori; Daniela Poli; Emilia Antonucci; Danilo Menichelli; Francesco Violi; Gualtiero Palareti; Pasquale Pignatelli; ; Sophie Testa; Oriana Paoletti; Corrado Lodigiani; Paola Ferrazzi; Ilaria Quaglia; Nadia Coffetti; Rosa Marotta; Varusca Brusegan; Orazio Bergamelli; Alzano Lombardo; Roberto Facchinetti; Giuseppina Serric...; Silvia Sarpau; Francesca Brevi; Lariana Como; Pietro Falco; Guarino Silverio; Catello Mangione; Giacomo Bellomo; Serena Masottini; Alessandra Cosenza; Lucia Ruocco; Paolo Chiarugi; Monica Casini; Arturo Cafolla; Antonietta Ferretti; Giorgia Micucci; Serena Rupoli; Lucia Canafoglia; Paolo Pedico; Rita Galasso; Rosa Rotunno; Raffaele Dimiccol...; Antonio Insana; Paolo Valesella; Angelo Santoro; Francesco Marongiu; Doris Barcellona; Vittorio Pengo; Gentian Denas; Carmelo Paparo; Eugenio Bucherini; Flavia Tani; Enrico Carioli; Tommasa Vicario; Mirella Saliola; Lucilla Masciocco; Pasquale Saracino; Angelo Benvenuto; Anna Turrini; Stefano Ciaffone; Andrea Toma; Pietro Barbera; Paolo Gresele; Tiziana Fierro; Stefano Pasquino; Lucia La Rosa; Rino Morales; Francesco Ronchi; Giuseppe Isu; Teresa Lerede; Luca Barcella; Rosanna Crisantemo; Luciano Suriano; Luciano Lorusso; Mario Sarlo; Pasquale Carrato; Carmine Oricchio; Elvira Grandone; Donatella Colaizzo; Maurizio Molinatti
• Keywords: Adult; Heart Valve Prosthesis Implantation; Male; Anticoagulants; Middle Aged; Heart Valves; 3. Good health; 03 medical and health sciences; sex; anticoagulant; mechanical prosthetic;heart valves; mortality; 0302 clinical medicine; Italy; Risk Factors; Aortic Valve; Heart Valve Prosthesis; Humans; Female; Aged

Background Vitamin K antagonists (VKAs) reduce thromboembolism in patients with mechanical prosthetic heart valves (MPHV). It is unclear whether a sex-based difference MPHV regarding valve site, anticoagulation quality, and mortality risk does exist. Methods We analysed 2111 from the nationwide PLECTRUM study promoted by Italian Federation of Anticoagulation Clinics (FCSA). site MPHV, as assessed time therapeutic range (TiTR), women men. Results The mean age was 56.8 ± 12.3 years. Women were older lower prevalence ischemic disease smoking habit higher atrial fibrillation at baseline. Aortic more frequent men (74.7% vs 43.3%, P < .001), whereas mitral (41.1% 17.6%, .001) mitro-aortic (15.6% 7.7%, MPVH women. association between female sex mitral/mitro-aortic remained multivariable logistic regression analysis (Odds Ratio 3.623, 95% Confidence Interval [CI] 2.947-4.455, .001). Regarding showed TiTR (63.0 19.4 57.5 19.2, proportion 60% (54.9% During follow-up 123 months (21 665 pt-years), 152 deaths occurred (0.7%/year); 83 aortic (0.63%/year) 69 (0.81%/year) group. At Cox proportional hazard analysis, not associated (HR 0.953, 95%CI 0.678 1.340, = .783). Conclusions Female independently MPHV. Despite women, did differ two groups.