The Prospective Randomized On-X Valve Anticoagulation Clinical Trial (PROACT): Lower is better, but is it good enough?

Authors

  • Ismail Bouhout Department of Cardiac Surgery, Montreal Heart Institute, Université de Montreal, Quebec, Canada
  • Ismail El-Hamamsy Department of Cardiac Surgery, Montreal Heart Institute, Université de Montreal, Quebec, Canada

DOI:

https://doi.org/10.21542/gcsp.2019.2

Abstract

Due to their durability, mechanical prostheses are frequently used for aortic valve replacement (AVR) in young adults. However, these valves are thrombogenic and require lifelong anticoagulation. Over the last few decades, efforts have been made towards the lowering of INR targets in an effort to reduce bleeding events without influencing the thromboembolic risk. The Prospective Randomized On-X Valve Anticoagulation Clinical Trial (PROACT) was designed to compare standard versus low anticoagulation targets in high-risk patients undergoing mechanical AVR with the ON-X prosthesis.

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Published

2019-04-14

Issue

Section

Lessons from the trials