Low-dose anticoagulation therapy used with new design mechanical heart valve lowers bleeding risk

Presentation at 93rd AATS Annual Meeting describes preliminary results

2013-05-06

(Press-News.org) Minneapolis, MN, May 6, 2013 – For more than 40 years, patients under 65 years of age requiring heart valve replacement have had to choose between a mechanical valve that offers life-long durability but requires aggressive warfarin anticoagulation or a biological (cow or pig) valve that will wear out in 10-20 years but does not require anticoagulation. Aggressive warfarin anticoagulation is accompanied by significant annual risk of bleeding, while inadequate anticoagulation of a mechanical artificial valve has been associated with high risk of clotting problems that can cause strokes.

A newer generation mechanical heart valve, manufactured by On-X Life Technologies, Austin, TX, has several design features that make it more efficient and less likely to clot. The FDA is allowing a randomized trial to be conducted to determine whether it is safe and effective to treat patients with an On-X mechanical aortic valve with less aggressive anticoagulation than has previously been recommended by the American Heart Association and American College of Cardiology.

In an interim report to be presented at the 93rd AATS Annual Meeting in Minneapolis on May 6, 2013, John D. Puskas, MD, Professor and Associate Chief of the Division of Cardiothoracic Surgery, Emory University School of Medicine, Athens, GA, and his co-investigators show that lower dose anticoagulation therapy, combined with low-dose aspirin, resulted in a reduction of 55 to 60% of the incidence of adverse bleeding events without significant increases in stroke, transient ischemic attack or total neurological events when used in conjunction with the On-X mechanical aortic valve.

As part of the Prospective Randomized On-X Anticoagulation Clinical Trial (PROACT), a control group of patients received standard treatment of warfarin administered to maintain a target range of the International Normalized Ratio (INR) of 2.0-3.0. The second treatment group received low-dose warfarin, targeting an INR of 1.5-2.0.

From June 2006 until October 2009, 375 Aortic Valve Replacement (AVR) patients were randomized into control (190) and treatment (185) groups three months after surgery. All patients had received standard therapy for the first 3 months including aspirin 81 mg daily. Mean age was 55.8 years in the control group and 54.1 years in the treatment group. Approximately 80% of the patients were male and 93% were in sinus rhythm before valve replacement. Patients were followed for an average of 3.82 years.

Dr. Puskas concludes that "Anticoagulation may be safely reduced in AVR patients after implantation of this approved bileaflet mechanical prosthesis. In combination with low-dose aspirin, this therapy resulted in significantly lower risk of bleeding than customary aggressive anticoagulation, without significant increase in clots or strokes." ### END

ELSE PRESS RELEASES FROM THIS DATE:

Activity of cancer inducing genes can be controlled by the cell's skeleton

2013-05-06

Cancer is a complex disease, in which cells undergo a series of alterations, including changes in their architecture; an increase in their ability to divide, to survive and to invade new tissues or metastasis. A category of genes, called oncogenes, is critical during cancer progression, as they codify proteins whose activity favours the development of cancer. One of these molecules, Src, is implicated in a large number of human cancers. However, it is still not clear how healthy cells constrain its activity not to become tumorous. In the latest issue of the journal Oncogene*, ...

Progerin's 'discrimination' may contribute to fatal disease HGPS

2013-05-06

A mutant protein responsible for Hutchinson-Gilford Progeria syndrome (HGPS) bars large proteins from entering the nucleus, according to a study in The Journal of Cell Biology. The culprit in HGPS, a fatal disease that resembles premature aging, is a protein variant called Progerin. This defective protein impairs cells in many ways, including reducing nuclear levels of the RanGTPase. Ran is crucial for nuclear import and export, as it stimulates unloading of cargo that has just entered the nucleus and loading of cargo that's ready to exit. Progerin also impedes the import ...

Wip1 could be new target for cancer treatment

2013-05-06

Researchers have uncovered mutations in the phosphatase Wip1 that enable cancer cells to foil the tumor suppressor p53, according to a study in The Journal of Cell Biology. The results could provide a new target for the treatment of certain cancers. Like a battlefield surgeon who has to decide which casualties can be saved, p53 performs triage on cells with injured DNA. If the damage is serious, p53 spurs the cells to die or stop proliferating. But after milder hits, p53 activates a DNA damage response (DDR) mechanism, which instigates repairs, and temporarily prevent ...

New Canadian guidelines for treating fibromyalgia

2013-05-06

Physicians from the McGill University Health Centre (MUHC) and the University of Calgary have published a review article in the CMAJ (Canadian Medical Association Journal) to help family doctors diagnose and treat fibromyalgia. The article represents the first time researchers have published Canadian guidelines to help manage the condition. Fibromyalgia is a chronic condition that affects the central nervous system causing pain throughout the body. It is often accompanied by fatigue, depression and sleep problems. It affects mostly women and their multiple symptoms ...

Ubiquitous engineered nanomaterials cause lung inflammation, study finds

2013-05-06

(SACRAMENTO, Calif.) -- A consortium of scientists from across the country has found that breathing ultrafine particles from a large family of materials that increasingly are found in a host of household and commercial products, from sunscreens to the ink in copy machines to super-strong but lightweight sporting equipment, can cause lung inflammation and damage. The research on two of the most common types of engineered nanomaterials is published online today in Environmental Health Perspectives, the journal of the National Institute of Environmental Health Sciences (NIEHS). ...

LCSB discovers endogenous antibiotic in the brain

2013-05-06

Luxembourg, 6 May 2013 – Scientists from the Luxembourg Centre for Systems Biomedicine (LCSB) of the University of Luxembourg have discovered that immune cells in the brain can produce a substance that prevents bacterial growth: namely itaconic acid. Until now, biologists had assumed that only certain fungi produced itaconic acid. A team working with Dr. Karsten Hiller, head of the Metabolomics Group at LCSB, and Dr. Alessandro Michelucci has now shown that even so-called microglial cells in mammals are also capable of producing this acid. "This is a ground breaking result," ...

Schools may help close gap to mental health services for adolescents with mental disorders

2013-05-06

Washington D.C., May 6, 2013 – A study published in the May 2013 issue of the Journal of the American Academy of Child and Adolescent Psychiatry found that mental health resources provided by schools are significantly associated with whether adolescents with mental disorders receive needed mental health services. In particular, adolescents with disorders attending schools that engage in early identification of emotional problems, are significantly more likely to receive mental health services. Using data from the National Comorbidity Survey Replication Adolescent Supplement ...

Reversal of the black widow myth

2013-05-06

VIDEO: Reverse cannibalism: Some male spiders prefer to eat old females rather than mate with them. Click here for more information. The Black Widow spider gets its name from the popular belief that female spiders eat their male suitors after mating. However, a new study has shown that the tendency to consume a potential mate is also true of some types of male spider. The study by Lenka Sentenska and Stano Pekar from Masaryk University in the Czech Republic finds that male ...

Possible treatment for serious blood cancer

2013-05-06

A single antibody could be the key to treating multiple myeloma, or cancer of the blood, currently without cure or long-term treatment. "We tested the antibody in various ways, including on tumour cells from myeloma patients that have been transplanted into mice. The tests showed that the antibody is able to destroy myeloma cells", explains Markus Hansson, a researcher at Lund University in Sweden. Using a 'biological library' of thousands of antibodies from the company BioInvent in Lund, the team singled out antibody BI-505, shown to have a powerful effect on the ...

Researchers reveal new more precise method of performing electroconvulsive therapy

2013-05-06

Philadelphia, PA, May 6, 2013 - Electroconvulsive therapy (ECT) is the most effective acute treatment for severe major depression. However, even with newer forms of ECT, there remains a significant risk of adverse cognitive effects, particularly memory problems. Current theories hold that the regions that need to be stimulated to treat the depression (the cortex) are different and separate from the regions that result in memory problems (the hippocampus and temporal lobes). Theoretically, a more precise form of ECT could have all of the efficacy and few or none of the ...

Low-dose anticoagulation therapy used with new design mechanical heart valve lowers bleeding risk

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: