Journal Article

Health technology assessment of oral anticoagulation following heart valve replacement

M. Perleth and R. Busse

in European Heart Journal Supplements

Published on behalf of European Society of Cardiology

Volume 3, issue suppl_Q, pages Q60-Q64
Published in print December 2001 | ISSN: 1520-765X
Published online December 2001 | e-ISSN: 1554-2815 | DOI: http://dx.doi.org/10.1016/S1520-765X(01)90045-8
Health technology assessment of oral anticoagulation following heart valve replacement

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Aims The purpose of this report is to define the role that health technology assessment (HTA; a discipline in which both health outcomes and associated economic variables are investigated) can play in determining the effects of various anticoagulation regimens after mechanical heart valve replacement.

Method and results A review of literature, including meta-analyses and primary studies of oral anticoagulation after heart valve replacement, was conducted. The review revealed that a combination of low-dose anticoagulation and antithrombotic therapy is more beneficial than oral anticoagulation or antiplatelet therapy alone. The addition of high-dose antiplatelet therapy appeared to increase risk for haemorrhagic events, which was in constrast to the effect of low-dose antiplatelet therapy alone. However, the results from earlier studies are not always comparable to those of recent ones because of different reporting methods, various follow-up durations, and a tendency to report outcomes globally rather than presenting stratified analyses.

Conclusion HTA is as a tool with which to determine the most cost-effective therapy for each patient group. Various patient populations should be considered (stratified by sex, type and position of valve) within the scope of a comprehensive HTA, as well as therapeutic options. However, any HTA should be viewed critically and in light of the literature on which it is based.

Keywords: Anticoagulation; biomedical; heart valve replacement; meta-analysis; systematic review; technology assessment

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine

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