{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:49:25Z","timestamp":1773708565616,"version":"3.50.1"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:00:00Z","timestamp":1732060800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Health, Labor and Welfare, Japan","award":["23AA2003"],"award-info":[{"award-number":["23AA2003"]}]},{"name":"Ministry of Health, Labor and Welfare, Japan","award":["22AA2003"],"award-info":[{"award-number":["22AA2003"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The appropriate antithrombotic regimen after a Fontan operation is yet to be elucidated. Hence, this study aimed to compare the incidence of thromboembolic events in patients with and without receiving warfarin for thromboprophylaxis in a large post-Fontan population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>This retrospective cohort study used data from the Diagnosis Procedure Combination database in Japan between April 2011 and March 2022. We identified all patients who underwent a Fontan operation and excluded those who were born before 2010, died during the hospitalization or received mechanical heart replacement. Propensity score overlap weighting was performed between patients discharged with warfarin (with or without aspirin) and the control group (only aspirin or neither aspirin nor warfarin). Cox and Fine-Gray hazards models compared thromboembolic and bleeding events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>We identified 2007 eligible patients, including 1670 warfarin users and 337 non-users. The mean follow-up duration was 2.1\u2009years. The crude proportions of thromboembolic events were 3.0% and 3.0% and those of bleeding events were 0.4% and 0.3% in the warfarin and control groups, respectively. There was no significant difference in thromboembolic events between the groups (sub-distribution hazard ratio: 0.77; 95% confidence interval 0.39\u20131.51; P\u2009=\u20090.45) or bleeding events (sub-distribution hazard ratio: 0.78; 95% confidence interval 0.09\u20137.03; P\u2009=\u20090.83).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Warfarin use at discharge after a Fontan operation may not be necessary for thromboembolism prophylaxis in paediatric patients, based on large-scale real-world data, with a mean postoperative follow-up duration of 2.1\u2009years. There is room for further studies to reconsider routine warfarin use in patients post-Fontan operation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezae413","type":"journal-article","created":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T08:39:33Z","timestamp":1732091973000},"source":"Crossref","is-referenced-by-count":2,"title":["Association between warfarin use and thromboembolic events in patients post-Fontan operation: propensity-score overlap weighting analyses"],"prefix":"10.1093","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8959-0508","authenticated-orcid":false,"given":"Wakana","family":"Maki","sequence":"first","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo , Tokyo,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shotaro","family":"Aso","sequence":"additional","affiliation":[{"name":"Department of Real-world Evidence, Graduate School of Medicine, The University of Tokyo , Tokyo,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Inuzuka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The University of Tokyo , Tokyo,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of Health Services Research, Graduate School of Medicine, The University of Tokyo , Tokyo,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyohide","family":"Fushimi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences , Tokyo,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideo","family":"Yasunaga","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo , Tokyo,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,11,19]]},"reference":[{"key":"2024112818522935400_ezae413-B1","doi-asserted-by":"crossref","first-page":"e234","DOI":"10.1161\/CIR.0000000000000696","article-title":"Evaluation and management of the child and adult with Fontan circulation: a scientific statement from the American Heart Association","volume":"140","author":"Rychik","year":"2019","journal-title":"Circulation"},{"key":"2024112818522935400_ezae413-B2","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1053\/j.semtcvs.2020.12.008","article-title":"Early thromboprophylaxis initiation is associated with reduced 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