AIMS The aim of this study was to determine the incidence of valve-related complications in patients with a mechanical aortic valve prosthesis and to identify risk factors for an adverse outcome. METHODS AND RESULTS In the 424 patients, event-free survival rates 5 and 10 years after aortic valve replacement were 62% and 37%, respectively. The linearized incidence of thromboembolic events was ...

OBJECTIVES This study attempted to determine the optimal intensity of anticoagulant therapy in patients after myocardial infarction. BACKGROUND Treatment with oral anticoagulant therapy entails a delicate balance between over- (risk of bleeding) and under-anticoagulation (risk of thromboemboli). The optimal intensity required to prevent the occurrence of either event (bleeding or thromboembol...

OBJECTIVE Postcardiopulmonary bypass hemorrhage remains a serious complication of cardiac surgery. Given concerns regarding adverse effects of blood product transfusion and limited efficacy of current antifibrinolytics, procoagulant medications, including recombinant factor VIIa (rFVIIa) and factor eight inhibitor bypass activity (FEIBA), increasingly have been used in managing refractory bleed...

High Plasma Brain Natriuretic Peptide Level in Thromboembolism Patients Associated With Nonvalvular Atrial Fibrillation: Cause or Effect? To the Editor: We read with great interest the recent article by Shimizu et al1 entitled “High Plasma Brain Natriuretic Polypeptide Level as a Marker of Risk for Thromboembolism in Patients With Nonvalvular Atrial Fibrillation.” Although in this article the a...

An increasing number of patients who are receiving anticoagulation or antiplatelet therapy require cutaneous surgery. Such pharmacotherapies are usually suspended based on experience in gynecologic, thoracic, and abdominal surgery. However, this practice may increase the risk of suffering a thromboembolic event. We review perioperative management of anticoagulant and antiplatelet therapy, compl...

High Plasma Brain Natriuretic Peptide Level in Thromboembolism Patients Associated With Nonvalvular Atrial Fibrillation: Cause or Effect? To the Editor: We read with great interest the recent article by Shimizu et al1 entitled “High Plasma Brain Natriuretic Polypeptide Level as a Marker of Risk for Thromboembolism in Patients With Nonvalvular Atrial Fibrillation.” Although in this article the a...

Plasma and urine concentrations of protein S were measured in five children with steroid-resistant nephrotic syndrome. It was found that plasma free protein S was reduced in three out of the five patients studied. Thus, acquired free protein S deficiency does occur in children with nephrotic syndrome and is one of many factors which may place them at risk for a thromboembolic event.

OBJECTIVES While the short-term (<7-day) safety and efficiency of electrical cardioversion for emergency department (ED) patients with atrial fibrillation or flutter have been established, the 30-day outcomes with respect to stroke, thromboembolic events, or death have not been investigated. METHODS A two-center cohort of consecutive ED patients undergoing cardioversion for atrial fibrillatio...