Abstract
700.35 Rivaroxaban in Mechanical Aortic Valve Patients With Warfarin Resistance: Proof of Concept
JACC. Cardiovascular interventions, Vol.18(4 Supplement), pp.S112-S112
02/24/2025
DOI: 10.1016/j.jcin.2025.01.397
Abstract
Background
Anticoagulation in patients with warfarin resistance especially mechanical aortic and mitral valves (AV) can be challenging. Data regarding safety and efficacy of direct oral anticoagulants (DAOCs) safety and efficacy in this population are limited. This case series aimed to determine the safety and efficacy of rivaroxaban in patients with mechanical aortic valves who failed to reach target international normalized ratio (INR) despite warfarin therapy.
Methods
A total of 5 patients with mechanical AV who failed to reach a target INR of 2.0 to 3.0 on warfarin therapy with dose of mean 12.08±3.2 mg for 3 months were included. Patients were transitioned to rivaroxaban with a dose of 15 mg twice daily. Transthoracic echocardiography with emphasis on valve velocities and valve thrombosis at baseline with a follow-up at 3, 6, and 12 months was done. Clinical outcomes included incidence of thromboembolic events and major bleeding complications over a 12-month follow-up. Informed consent was obtained from all patients prior to enrollment.
Results
A total of 5 patients were enrolled, 80% were males, with a mean age of 58.8±11.92 year. Baseline left ventricular ejection fraction (LVEF) was 42±12.08%. Aortic valve maximal velocity (AV Vmax) was 2.32±0.25 m/s with a Doppler Velocity Index (DVI) of 0.424±0.075. During 12-month follow-up, no significant changes in echocardiographic parameters, including AV velocities and DVI, were observed. Additionally, no major bleeding incidents or evidence of distal embolization were reported.
Conclusion
This case series showed that rivaroxaban was well tolerated as an alternative for anticoagulation in patients with mechanical aortic valves and warfarin resistance. Further large-scale studies are needed to validate these findings.
Details
- Title: Subtitle
- 700.35 Rivaroxaban in Mechanical Aortic Valve Patients With Warfarin Resistance: Proof of Concept
- Creators
- Mahmoud Abdelnabi - Mayo Clinic in ArizonaMohammad Sanhoury - Alexandria UniversityRamzi Ibrahim - Mayo Clinic in ArizonaYehia Saleh - University of IowaGirish Pathangey - Mayo Clinic in ArizonaAbdallah Almaghraby - Ibrahim Bin Hamad Obaidullah, Ras Al Khaimah, United Arab Emirates
- Resource Type
- Abstract
- Publication Details
- JACC. Cardiovascular interventions, Vol.18(4 Supplement), pp.S112-S112
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jcin.2025.01.397
- ISSN
- 1936-8798
- Language
- English
- Date published
- 02/24/2025
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984795474902771
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