{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T04:44:50Z","timestamp":1782621890733,"version":"3.54.5"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100002463","name":"General Motors Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002463","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ibrain"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Hemorrhagic stroke (HS) remains a serious and potentially disabling complication following heart valve replacement (HVR). We aimed to evaluate the incidence and predictors of HS among mechanical HVR patients in Bangladesh. The Multidimensional Approach of Genotype and Phenotype In Stroke Etiology (MAGPIE) is an ambispective study recruited 568 consecutive HVR patients who had long\u2010term (\u22656 months) warfarin therapy between January 2010 and December 2024. Among the 568 HVR patients, 4.4% experienced HS, with a mortality rate of 52%, and the median age was 40 years (interquartile range [IQR]: 32\u201345). The median duration of warfarin uses among mechanical heart valve patients with HS varied by procedure: 63 months (IQR: 48\u201386) for mitral valve replacement, 60 months (12\u201385) for aortic valve replacement, 96 months (52\u2013101.50) for double valve replacement, and 42 months (24\u201360) for patients undergoing coronary artery bypass grafting (CABG) with valve replacement. Additionally, a receiver operating characteristic curve analysis identified 104 months as the discriminatory threshold for warfarin therapy duration in predicting post\u2010HVR HS onset. An age\u2010 and sex\u2010adjusted logistic regression model identified severe pulmonary hypertension (odds ratio [OR] 4.44; 95% confidence interval [CI] 1.15\u201317.04;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.02) and warfarin therapy duration \u2265104 months (OR 1.99; 95% CI 1.00\u20133.76;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.04) as independent predictors of HS in patients with mechanical HVR. Severe pulmonary hypertension was associated with a 4.4\u2010fold higher risk and warfarin therapy beyond 104 months with a twofold higher risk of HS among patients with mechanical HVR.\n                  <\/jats:p>","DOI":"10.1002\/ibra.70020","type":"journal-article","created":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T08:15:26Z","timestamp":1779005726000},"page":"250-258","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of hemorrhagic stroke in warfarin\u2010treated patients following heart valve replacement: Findings from the MAGPIE study"],"prefix":"10.1002","volume":"12","author":[{"given":"Dipannita","family":"Adhikary","sequence":"first","affiliation":[{"name":"Department of Biological Sciences Royal Holloway University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8551-7185","authenticated-orcid":false,"given":"Md. Abdullah","family":"Yusuf","sequence":"additional","affiliation":[{"name":"Department of Microbiology National Institute of Neurosciences and Hospital Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AM Nayeem","family":"Parvez","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Impulse Hospital and Research Centre Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheikh M. B.","family":"Faruque","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery National Institute of Cardiovascular Diseases Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santo","family":"Barman","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Impulse Hospital and Research Centre Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adneen","family":"Moureen","sequence":"additional","affiliation":[{"name":"Department of Microbiology Armed Forces Medical College Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke J.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Academic Cardiovascular Unit South Tees NHS Foundation Trust Middlesbrough UK"},{"name":"Department of Surgery Hull York Medical School York UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aziz","family":"Momin","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery St George's University Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkatachalam","family":"Chandrasekaran","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery St George's University Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asit B.","family":"Adhikary","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Impulse Hospital and Research Centre Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1927-5023","authenticated-orcid":false,"given":"Redoy","family":"Ranjan","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Academic Cardiovascular Unit South Tees NHS Foundation Trust Middlesbrough UK"},{"name":"Department of Cardiac Surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2007.02.002"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3329\/cardio.v13i1.50561"},{"issue":"2","key":"e_1_2_11_4_1","first-page":"341","article-title":"Effect of VKORC1 and CYP2C9 polymorphisms on warfarin dose requirement in Bangladeshi population","volume":"30","author":"Chowdhury ZS","year":"2017","journal-title":"Pak J Pharm Sci"},{"issue":"6","key":"e_1_2_11_5_1","first-page":"579","article-title":"Therapeutic audit of patients on warfarin in an anticoagulation clinic of a tertiary care hospital","volume":"173","author":"Sridharan K","year":"2022","journal-title":"Clin Ter"},{"issue":"3","key":"e_1_2_11_6_1","first-page":"210","article-title":"Thromboembolic and hemorrhagic complications in patients with prosthetic heart valves cared for in a tertiary care center. What have we learned?","volume":"159","author":"S\u00e1nchez\u2010Medina FF","year":"2023","journal-title":"Gac Med Mex"},{"issue":"10","key":"e_1_2_11_7_1","first-page":"2242","article-title":"[Clinical application of anticoagulation treatment with warfarin after prosthetic heart valve replacement: a single center\u2010based survey]","volume":"30","author":"Liu Y","year":"2010","journal-title":"Nan Fang Yi Ke Da Xue Xue 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