• Posted November 19, 2024

Newer Blood Thinner Cuts Odds for Stroke After Heart Valve Surgery

Japanese researchers say they have found a pill that works as well as existing medication to prevent blood clots after heart valve surgery, with fewer trips to the doctor.

Unlike warfarin, the standard treatment, edoxaban does not require regular monitoring of blood clotting activity and doesn't interact with other meds.

"Edoxaban could make life easier for patients recovering from heart valve surgery," said study leader Dr. Chisato Izumi, of the National Cerebral and Cardiovascular Center in Suita, Japan. 

"Since this medication does not require regular blood tests to monitor anticoagulation activity and can be taken in a fixed dose, without fears of interaction with food or other medications, it reduces the burden on patients and improves their quality of life, especially in those crucial first few months after surgery," she added.

Izumi presented her team's findings Monday at a meeting of the American Heart Association in Chicago. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.

The U.S. Food and Drug Administration approved edoxaban in 2015 for patients with a form of atrial fibrillation (A-fib) caused by rapid and irregular beating of the heart's top chambers, not a heart valve problem.

For this trial, researchers compared its use to warfarin in about 400 patients in Japan who had heart valve replacement surgery. Participants received either edoxaban or warfarin for 12 weeks.

Compared to warfarin, edoxaban was as effective -- or even more so -- in preventing stroke and blood clots, researchers said. 

In all, 0.5% of edoxaban patients had a stroke or embolism compared to 1.5% of those who took warfarin. 

However, 4.1% in the edoxaban group had major bleeding, compared to 1% of the warfarin group. One patient taking warfarin had a fatal brain hemorrhage, but there were no brain hemorrhages or fatal bleeding in edoxaban patients.

None of the edoxaban patients suffered a blood clot in the heart, but 1% of warfarin patients did.

Finally, those taking edoxaban did have higher rates of gastrointestinal bleeding than those taking warfarin (2.1% versus 0%).

"Our findings show that edoxaban could help prevent blood clots as effectively as warfarin, indicating it is a viable post-surgery treatment alternative to consider for patients who have received a bioprosthetic heart valve replacement," Izumi said in a meeting news release.

Researchers said additional study is needed to learn which patients are more likely to bleed if they take edoxaban, and how to reduce that risk.

They noted that both patients and doctors knew which medication participants were receiving, which could have biased the results. The study did not include patients whose valves were replaced with man-made devices.

More information

MedlinePlus has more about blood thinners and how they work.

SOURCE: American Heart Association, news release, Nov. 17, 2024