{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T19:12:32Z","timestamp":1768677152110,"version":"3.49.0"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2014]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Limited evidence exists to guide the use of early parenteral anticoagulation following mechanical heart valve replacement (MVR). The purpose of this study was to compare the 30-day rates of thrombotic and bleeding complications for MVR patients receiving therapeutic versus prophylactic dose bridging regimens. In this retrospective cohort study we reviewed anticoagulation management and outcomes of all patients undergoing MVR at five Canadian hospitals between 2003 and 2010. The primary efficacy outcome was thromboembolism (stroke, transient ischaemic attack, systemic embolism or valve thrombosis) and the primary safety outcome was major bleeding at 30-days. Outcomes were compared using a logistic regression model adjusting for propensity score and in a 1:1 propensity matched sample. A total of 1777 patients underwent mechanical valve replacement, of whom 923 received therapeutic dose bridging anticoagulation and 764 received prophylactic dose bridging postoperatively. Sixteen patients (1.8 %) who received therapeutic dose bridging and fifteen patients (2.1 %) who received prophylactic dose bridging experienced the primary efficacy outcome (odds ratio [OR] 0.90; 95 % confidence interval [CI], 0.37 to 2.18, p=0.81). Forty-eight patients (5.4 %) in the therapeutic dosing group and 14 patients (1.9 %) in the prophylactic dosing group experienced the primary safety outcome of major bleeding (OR 3.23; 95 % CI, 1.58 to 6.62; p=0.001). The direction of the effects, their magnitude and significance were maintained in the propensity matched analysis. In conclusion, we found that early after mechanical valve replacement, therapeutic dose bridging was associated with a similar risk of thromboembolic complications, but a 2.5 to 3-fold increased risk of major bleeding compared with prophylactic dose bridging.<\/jats:p>","DOI":"10.1160\/th14-03-0284","type":"journal-article","created":{"date-parts":[[2014,9,3]],"date-time":"2014-09-03T05:36:40Z","timestamp":1409722600000},"page":"1120-1128","source":"Crossref","is-referenced-by-count":17,"title":["Efficacy and safety of early parenteral anticoagulation as a bridge to warfarin after mechanical valve replacement"],"prefix":"10.1160","volume":"112","author":[{"given":"Joseph","family":"Mathew","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Spyropoulos","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arif","family":"Yusuf","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Vincent","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Eikelboom","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga","family":"Shestakovska","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Fremes","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Noora","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linrui","family":"Guo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Peterson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Menaka","family":"Pai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Whitlock","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2017,11,29]]},"reference":[{"key":"10.1160\/TH14-03-0284-1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.72.5.1059"},{"key":"10.1160\/TH14-03-0284-2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.89.2.635"},{"key":"10.1160\/TH14-03-0284-3","doi-asserted-by":"crossref","unstructured":"Butchart EG, Gohlke-B\u00e4rwolf C, Antunes MJ, et al.; Working Groups on Valvular Heart Disease, Thrombosis, and Cardiac Rehabilitation and Exercise Physiology. Recommendations for the management of patients after heart valve surgery. Eur Heart J 2005; 26: 2463-2471","DOI":"10.1093\/eurheartj\/ehi426"},{"key":"10.1160\/TH14-03-0284-4","doi-asserted-by":"crossref","unstructured":"Whitlock RP, Sun JC, Fremes SE, et al.; American College of Chest Physicians. Antithrombotic and thrombolytic therapy for valvular disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141 (2 Suppl): e576S-600S","DOI":"10.1378\/chest.141.4.1129b"},{"key":"10.1160\/TH14-03-0284-5","doi-asserted-by":"crossref","unstructured":"Bonow RO, Carabello BA, Chatterjee K, et al.; American College of Cardiology\/American Heart Association Task Force on Practice Guidelines. 2008 focused update incorporated into the ACC\/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. 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Perioperative bridging therapy with unfractionated heparin or low-molecular-weight heparin in patients with mechanical prosthetic heart valves on long-term oral anticoagulants (from the REGIMEN Registry). Am J Cardiol 2008; 102: 883-889","DOI":"10.1016\/j.amjcard.2008.05.042"},{"key":"10.1160\/TH14-03-0284-16","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.105221"},{"key":"10.1160\/TH14-03-0284-17","doi-asserted-by":"crossref","unstructured":"Birnie DH, Healey JS, Wells GA, et al.; BRUISE CONTROL Investigators. Pacemaker or defibrillator surgery without interruption of anticoagulation. 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