Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
NOAC in Adult Congenital Heart Disease patients: a single-center experience
Session:
Posters (Sessão 3 - Écran 1) - Cardiopatias Congénitas no Adulto
Speaker:
Bruno M. Rocha
Congress:
CPC 2022
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
20. Congenital Heart Disease and Pediatric Cardiology
Subtheme:
20.4 Congenital Heart Disease – Treatment
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Dr. Bruno Rocha; Sérgio Maltês; Gonçalo Cunha; Mariana Paiva; Catarina Brízido; Carlos Aguiar; Sérgio Madeira; Miguel Mendes
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><strong><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">Background: </span></span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">Adult Congenital Heart Disease (ACHD) patients at increased risk for thromboembolic events are often treated with oral anticoagulation. While vitamin-K antagonists have been the agent of choice for decades, the use of non-vitamin K oral antagonists (NOAC) is increasing. We aimed to assess the safety and effectiveness of NOAC in ACHD patients at our centre.</span></span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><strong><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">Methods:</span></span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">This is a single-centre study enrolling all patients with ACHD treated with a NOAC from inception to November 2021. Data was collected using a standardized questionnaire applied to all patients by means of a telephone visit, in parallel with a detailed retrospective chart review. The endpoints of interest included thromboembolic and haemorrhagic events, defined as per the standardized International Society on Thrombosis and Haemostasis (ISTH) scale.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><strong><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">Results:</span></span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">Overall, 36 ACHD patients were enrolled [mean age 53 ± 15 years; female sex – 66.7%; previous stroke – 33.3%; median HAS-BLED and CHA<sub>2</sub>DS<sub>2</sub>-VASc score – 1 (1-2) and 3 (2-5), respectively], predominantly with moderate or complex congenital defects (52.7%), of whom 14, 8, 8 and 4 were treated with rivaroxaban, apixaban, edoxaban and dabigatran, respectively. Two-thirds had their first NOAC prescription in the latest 3 years (</span></span></span></span><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif""><strong><span style="color:#0070c0">Figure 1</span></strong></span></span><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">). The most common indication for anticoagulation was atrial fibrillation or flutter (77.8%). Over a median time of 36 (18-63) months on NOAC treatment, there were no patients with thromboembolic events, whilst 13 (36.1%) had a haemorrhagic event –</span></span> <span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">annualized</span></span> <span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">event</span></span> <span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">rate</span></span> <span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">of</span></span> <span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">12.0</span></span> <span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">(6.9-24.1%).</span></span> <span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">All</span></span> <span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">bleeding events were minor,</span></span> <span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">most often self-limited gingival haemorrhage or epistaxis (n=7) or menorrhagia (n=3). Nasal cautery was needed to treat recurrent epistaxis in 3 patients, whilst 3 other required oral iron supplementation. The strongest predictor of any haemorrhage was a prior cardiovascular hospitalization (HR 3.88; p=0.027). </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><strong><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">Conclusions:</span></span></strong> </span></span></p> <p style="text-align:justify"><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">The use of NOAC in ACHD patients has been increasing in our centre, with encouraging results. The present findings suggest that NOAC are safe and may be effective for thromboembolic event prevention in heterogeneous forms of ACHD. </span></span><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif""> </span></span></span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site