Edoxaban could limit blood clots, ‘make life easier’ for heart valve surgery patients
Edoxaban may be a safe, effective alternative to warfarin when treating patients who undergo heart valve surgery, according to new data presented at the American Heart Association (AHA) 2024 Scientific Sessions in Chicago. In fact, it appears to deliver certain benefits not seen with warfarin.
Edoxaban is a direct oral anticoagulant (DOAC) approved by the U.S. Food and Drug Administration to treat nonvalvular atrial fibrillation. Care teams typically turn to warfarin, not DOACs, when their patients undergo heart valve surgery. These new data suggest edoxaban may offer significant potential.
“Currently, we can use only vitamin K antagonists such as warfarin for patients early after bioprosthetic valve surgery,” lead author Chisato Izumi, MD, PhD, a cardiology researcher with the National Cerebral and Cardiovascular Center in Suita, Japan, said in a statement. “However, warfarin has a narrow therapeutic range requiring frequent blood testing to monitor clotting activity, and it also interacts with other medications and food, which can be a challenge for patients and the health care professionals treating them.”
Izumi presented data based on her team’s study of nearly 400 patients with an average age of 73 years old who underwent surgical aortic valve replacement or surgical mitral valve surgery in Japan from 2022 to 2024. Patients were randomized to receive either edoxaban or warfarin for 12 weeks following treatment.
Overall, stroke or systemic embolisms were seen in 0.5% of edoxaban patients and 1.5% of warfarin patients. The major bleeding event rate was significantly higher for edoxaban patients—4.1% vs. 1%—but edoxaban was linked to no reports of fatal bleeding events or intracranial hemorrhages. Warfarin, meanwhile, was linked to a single report of a fatal cerebral hemorrhage.
The study’s authors also tracked intracardiac thrombi, noting that the edoxaban group experienced no blood clots in their hearts compared to an event rate of 1% for the warfarin group.
“Our findings show that edoxaban could help prevent blood clots and stroke 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 explained. “Edoxaban could make life easier for patients recovering from heart valve surgery. 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.”
The team did note that more research is still necessary. These findings have not yet been published in a peer-reviewed journal.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.