Position statement: Anticoagulation of patients with mechanical heart valves

In July a National Patient Safety Alert was issued by NHS England relating to choice of anticoagulant drugs prescribed to patients with mechanical heart valves.

The British Society of Echocardiography has joined with the British Heart Valve Society (BHVS), the Society for Cardiothoracic Surgeons (SCTS), the Primary Care Cardiovascular Society (PCCS), the British Congenital Cardiac Association (BCCA) and the British Cardiovascular Society (BCS) to develop a joint position statement to ensure our members have the appropriate information. 

This statement confirms  that, at present, none of the novel oral anticoagulant drugs (dabigatran, edoxaban, apixaban & rivaroxaban) are licensed for use in patients with mechanical heart valves and, in fact, they are contraindicated in patients with mechanical valves as per both European[3] and North American[4] clinical practice guidelines because of a higher incidence of thromboembolic complications when compared to warfarin.  On this basis, any patients with mechanical heart valves who are receiving novel oral anticoagulants instead of warfarin should be reviewed urgently.

We urge all members to read the statement in full by clicking the link below. 

Download the PDF