{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:31:15Z","timestamp":1762918275933,"version":"3.37.3"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T00:00:00Z","timestamp":1641168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,2]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: \u2018Are NOACs as safe and efficient as vitamin K antagonist regarding thromboembolic prophylaxis and major bleeding in patients with surgical bioprosthesis and atrial fibrillation within 3\u2009months of surgery?\u2019 Altogether more than 324 papers were found using the reported search, of which 6 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. The RIVER and ENAVLE trials showed non-inferiority of rivaroxaban (regarding mean time free from composite of death, major cardiovascular events or major bleeding at 12\u2009months) and edoxaban (composite of death, clinical thromboembolic events or asymptomatic intracardiac thrombosis; and major bleeding) when compared with vitamin K antagonist. These studies include a low number of patients within 3\u2009months of index surgery and overall low statistical power regarding this particular subgroup of patients. Data derived from lower evidence studies are compatible with the aforementioned findings. The available evidence suggests that non-vitamin K antagonist anticoagulants are as safe and as efficient as vitamin K antagonist regarding thromboembolic prophylaxis and bleeding event rates in patients with surgical bioprosthesis and atrial fibrillation within 3\u2009months of bioprosthesis implantation. However, this evidence is derived from a limited number of studies with important methodological limitations. Expanding non-vitamin K antagonist anticoagulant recommendation to the early postoperative period warrants more confirmatory research.<\/jats:p>","DOI":"10.1093\/icvts\/ivab363","type":"journal-article","created":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T20:11:52Z","timestamp":1639685512000},"page":"739-743","source":"Crossref","is-referenced-by-count":4,"title":["Are NOACs as safe and efficient as VKA regarding thromboembolic prophylaxis and major bleeding in patients with surgical bioprosthesis and atrial fibrillation within 3 months of surgery?"],"prefix":"10.1093","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5521-9232","authenticated-orcid":false,"given":"Pedro Lamares","family":"Magro","sequence":"first","affiliation":[{"name":"Department of Cardio-thoracic Surgery, Hospital de Santa Cruz, Carnaxide, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel","family":"Sousa-Uva","sequence":"additional","affiliation":[{"name":"Department of Cardio-thoracic Surgery, Hospital de Santa Cruz, Carnaxide, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,1,3]]},"reference":[{"key":"2022050515303232400_ivab363-B1","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/S1569-9293(03)00191-9","article-title":"Towards evidence-based medicine in cardiothoracic surgery: best BETS","volume":"2","author":"Dunning","year":"2003","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2022050515303232400_ivab363-B2","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1002\/clc.23178","article-title":"Efficacy and safety of apixaban vs warfarin in patients with atrial fibrillation and prior bioprosthetic valve replacement or valve repair: insights from the ARISTOTLE trial","volume":"42","author":"Guimar\u00e3es","year":"2019","journal-title":"Clin Cardiol"},{"key":"2022050515303232400_ivab363-B3","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1161\/CIRCULATIONAHA.116.026714","article-title":"Edoxaban for the prevention of thromboembolism in patients with atrial fibrillation and bioprosthetic valves","volume":"135","author":"Carnicelli","year":"2017","journal-title":"Circulation"},{"key":"2022050515303232400_ivab363-B4","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1056\/NEJMoa2029603","article-title":"Rivaroxaban in patients with atrial fibrillation and a bioprosthetic mitral valve","volume":"383","author":"Guimar\u00e3es","year":"2020","journal-title":"N Engl J Med"},{"key":"2022050515303232400_ivab363-B5","doi-asserted-by":"crossref","DOI":"10.1016\/j.jtcvs.2021.01.127","article-title":"Efficacy and safety of edoxaban in patients early after surgical bioprosthetic valve implantation or valve repair: a randomized clinical trial","author":"Shim","year":"2021","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022050515303232400_ivab363-B6","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1007\/s40261-020-00939-x","article-title":"Comparison of the efficacy and safety of direct oral anticoagulants and warfarin after bioprosthetic valve replacements","volume":"40","author":"Pasciolla","year":"2020","journal-title":"Clin Drug Investig"},{"key":"2022050515303232400_ivab363-B7","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1016\/j.athoracsur.2020.12.031","article-title":"Non-vitamin K antagonist oral anticoagulant vs warfarin for post cardiac surgery atrial fibrillation","volume":"112","author":"Nauffal","year":"2021","journal-title":"Ann Thorac Surg"}],"container-title":["Interactive CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/34\/5\/739\/43517508\/ivab363.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/34\/5\/739\/43517508\/ivab363.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T15:30:55Z","timestamp":1651764655000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/34\/5\/739\/6491900"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,3]]},"references-count":7,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,1,3]]},"published-print":{"date-parts":[[2022,5,2]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivab363","relation":{},"ISSN":["1569-9285"],"issn-type":[{"type":"electronic","value":"1569-9285"}],"subject":[],"published-other":{"date-parts":[[2022,5,1]]},"published":{"date-parts":[[2022,1,3]]}}}