Evidence map›Paper›PMID 38556579›Full record

Observational studyJournal of thrombosis and thrombolysis2024

Thromboembolic events after major bleeding events in patients with mechanical heart valves: a 13-year analysis.

Pascal Augustin, Stefan Andrei, Bernard Iung, Marylou Para, Peter Matthews, Christian de Tymowski, Nadine Ajzenberg, Philippe Montravers

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of thrombosis and thrombolysis, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 94% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 7 institutions in 3 countries.

Pascal AugustinDepartment of Anesthesiology and Critical Care, Groupe Hospitalier Bichat-Claude Bernard, Assistance Publique Hôpitaux de Paris, 46 Rue Henri Huchard, Paris, 75018, France. pascalaugustin@hotmail.com.
Stefan AndreiDepartment of Anesthesiology and Critical Care, Groupe Hospitalier Bichat-Claude Bernard, Assistance Publique Hôpitaux de Paris, 46 Rue Henri Huchard, Paris, 75018, France.
Bernard IungDepartment of Cardiology, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Bichat Claude Bernard, University of Paris, Paris, France.
Marylou ParaDepartment of Cardiovascular Surgery and Transplantation, Groupe Hospitalier Bichat-Claude Bernard, Assistance Publique Hôpitaux de Paris, Paris, France.
Peter MatthewsCentre de Recherche sur l'Inflammation, University of Paris, INSERM UMR 1149, CNRS ERL8252, Paris, France.
Christian de TymowskiDepartment of Anesthesiology and Critical Care, Groupe Hospitalier Bichat-Claude Bernard, Assistance Publique Hôpitaux de Paris, 46 Rue Henri Huchard, Paris, 75018, France.
Nadine AjzenbergLaboratory of Vascular Translational Science, University of Paris, INSERM UMR 1148, Paris, France.
Philippe MontraversDepartment of Anesthesiology and Critical Care, Groupe Hospitalier Bichat-Claude Bernard, Assistance Publique Hôpitaux de Paris, 46 Rue Henri Huchard, Paris, 75018, France.
Hôpital Bichat-Claude-Bernard · FRAssistance Publique – Hôpitaux de Paris · FRCentre National de la Recherche Scientifique · FRComputational Physics (United States) · USNorthwick Park Hospital · GBUniversité Claude Bernard Lyon 1 · FRUniversité Paris Cité · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Anticoagulation in patients with mechanical heart valves (MHV) is associated with a risk of major bleeding episodes (MBE). In case of MBE, anticoagulant interruption is advocated. However, there is lack of data regarding the thrombo-embolic events (TE) risk associated with anticoagulant interruption. The main objective of the study was to evaluate the rate and risk factors of 6-months of TEs in patients with MHV experiencing MBE. This observational study was conducted over a 13-year period. Adult patients with a MHV presenting with a MBE were included. The main study endpoint was 6-month TEs, defined by clinical TEs or an echocardiographic documented thrombosis, occurring during an ICU stay or within 6-months. Thromboembolic events were recorded at ICU discharge, and 6 months after discharge. Seventy-nine MBEs were analysed, the rate of TEs at 6-months was 19% CI [11-29%]. The only difference of presentation and management between 6-month TEs and free-TE patients was the time without effective anticoagulation (TWA). The Receiver Operator Characteristic curve identified the value of 122 h of TWA as a cut-off. The multivariate analysis identified early bleeding recurrences (OR 3.62, 95% CI [1.07-12.25], p = 0.039), and TWA longer than 122 h (OR 4.24, 95% CI [1.24-14.5], p = 0.021), as independent risk factors for 6-month TEs. A higher rate of TE was associated with anticoagulation interruption longer than 5 days and early bleeding recurrences. However, the management should still be personalized and discussed for each case given the heterogeneity of causes of MBE and possibilities of haemostatic procedures.

Indexed as

AnticoagulantsHeart Valve ProsthesisHemorrhageThromboembolismAgedFemaleHumansMaleMiddle AgedRisk FactorsAnticoagulantsMajor bleeding eventMechanical heart valveThromboembolic eventTime without anticoagulation

Identifiers

PMID38556579
OpenAlexW4393356924

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.