Back to Search
Start Over
Effects of vitamin K antagonist on aortic valve degeneration in non-valvular atrial fibrillation patients: Prospective 4-year observational study
- Source :
- Thrombosis research. 160
- Publication Year :
- 2017
-
Abstract
- Background The prevalence of atrial fibrillation (AF) is high in elder subjects. Our previous observational study suggested that vitamin K antagonist (VKA) promotes aortic valve degeneration, a principal cause of aortic stenosis in the elderly, and that angiotensin receptor blocker (ARB) attenuates its progression. This study aimed to prospectively investigate these observations in non-valvular AF patients. Methods Of enrolled 430 patients with calcification on no or one aortic valve leaflet, all of the planned 4-year follow-up data were obtained in 122 non-valvular AF patients treated with warfarin (warfarin group) and 101 patients with cardiovascular diseases and without AF and prescription of warfarin (non-warfarin group). Results Despite higher atherosclerotic risks in the non-warfarin group, 2 or 3 newly calcified leaflets emerged during 4 years in 18.0% of patients in the warfarin group and in 6.9% in the non-warfarin group (p = 0.014). Aortic valve area (AVA) did not significantly change in the non-warfarin group during the follow-up, but tended to decrease in the warfarin group (p = 0.057). Non-vitamin K antagonist oral anticoagulant got available in Japan after this study started, and warfarin was discontinued in 15 patients of the warfarin group. The reduction of AVA was significant in the remaining 107 patients on the continuous warfarin treatment (p = 0.002). The effects of ARB on AVA were obscure. Conclusion Major bleeding associated with VKA is well recognized. This study suggests that the development of aortic valve degeneration is another risk of long-term use of VKA in non-valvular AF patients with no or mild aortic valve degeneration.
- Subjects :
- Aortic valve
Male
medicine.medical_specialty
Angiotensin receptor
Time Factors
Vitamin K
medicine.drug_class
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Internal medicine
Atrial Fibrillation
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Prospective Studies
Aged
business.industry
Antagonist
Warfarin
Atrial fibrillation
Hematology
Vitamin K antagonist
medicine.disease
Stenosis
medicine.anatomical_structure
Echocardiography
Aortic Valve
cardiovascular system
Cardiology
Female
business
Calcification
medicine.drug
Follow-Up Studies
Subjects
Details
- ISSN :
- 18792472
- Volume :
- 160
- Database :
- OpenAIRE
- Journal :
- Thrombosis research
- Accession number :
- edsair.doi.dedup.....5eed76473f280ed5b96b5f9c512b8127