Adherence to American College of Cardiology/American Heart Association guidelines for the management of anticoagulation in patients with mechanical valves undergoing elective outpatient procedures

Ajay J. Kirtane, Aref M. Rahman, Pedro Martinezclark, Allen Jeremias, Todd B. Seto, Warren J. Manning

Research output: Contribution to journalArticle

5 Scopus citations


This study sought to establish the practice patterns of a diverse group of academic physicians, in the management of periprocedural anticoagulation for patients with mechanical heart valves, to study adherence to American College of Cardiology/American Heart Association (ACC/AHA) guidelines. Physicians (n = 140) were surveyed to assess strategies for the periprocedural anticoagulation of patients with bileaflet mechanical heart valves undergoing 2 common outpatient procedures. Six patient scenarios with graded risk profiles were presented for each valve location (mitral and aortic). In >90% of high-risk patient scenarios, for which the ACC/AHA guidelines recommend periprocedural anticoagulation, anticoagulation was recommended, with minimal differences between physician specialties. However, periprocedural anticoagulation was also recommended in >70% of non-high-risk scenarios, for which the ACC/AHA guidelines recommend no periprocedural anticoagulation. Noncardiologists recommended anticoagulation more often in non-high-risk patients (p <0.01), especially for patients with aortic valve prostheses. Thus, academic physicians appropriately recommend periprocedural anticoagulation for high-risk patients with mechanical heart valves who undergo elective procedures. However, these data specifically suggest variability in practice for non-high-risk patients that are discordant with current ACC/AHA guidelines, with differences by treating specialty especially notable in this risk subset.

Original languageEnglish
Pages (from-to)891-893
Number of pages3
JournalAmerican Journal of Cardiology
Issue number6
StatePublished - Mar 15 2006


ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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