Safety and Effectiveness of Early Aspirin Administration After Mitral Valve Repair

NCT ID: NCT06738992

Last Updated: 2024-12-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

384 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-11-14

Study Completion Date

2027-12-31

Brief Summary

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This study compares the efficacy and safety of two different antithrombotic drugs, warfarin and aspirin, in early application after mitral valve repair (MVRep). The objective is to verify whether the type of antithrombotic therapy affects clinical outcomes and the incidence of thromboembolic and bleeding complications within 3 months after MVRep, and to provide safe and effective antithrombotic treatment options for patients undergoing MVRep.

Detailed Description

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Patients were randomly assigned in a 1:1 ratio to two groups: the Warfarin Group and the Aspirin Group.

Warfarin Group: Anticoagulation therapy was initiated on the second day after surgery, starting at 4.5 mg once nightly, with adjustments made based on changes in the INR value.

Aspirin Group: Antiplatelet therapy was initiated on the second day after surgery with oral administration of Aspirin Enteric-coated Tablets (Bayer Aspirin) at a dose of 100 mg once daily.

For all patients, antithrombotic therapy was continued for at least 3 months post-surgery. Patients were scheduled for outpatient visits at 1, 4, 8, and 12 weeks following the surgical intervention.

Conditions

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Mitral Valve Repair Surgery

Keywords

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mitral valve repair surgery Warfarin Aspirin

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Warfarin Group

Anticoagulation therapy was initiated on the second day after surgery, starting at 4.5 mg once nightly, with adjustments made based on changes in the INR value.

Group Type ACTIVE_COMPARATOR

Warfarin

Intervention Type DRUG

Anticoagulation therapy was initiated on the second day after surgery, starting at 4.5 mg once nightly, with adjustments made based on changes in the INR value.

Aspirin Group

Antiplatelet therapy was initiated on the second day after surgery with oral administration of Aspirin Enteric-coated Tablets (Bayer Aspirin) at a dose of 100 mg once daily.

Group Type EXPERIMENTAL

Aspirin

Intervention Type DRUG

Antiplatelet therapy was initiated on the second day after surgery with oral administration of Aspirin Enteric-coated Tablets (Bayer Aspirin) at a dose of 100 mg once daily.

Interventions

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Aspirin

Antiplatelet therapy was initiated on the second day after surgery with oral administration of Aspirin Enteric-coated Tablets (Bayer Aspirin) at a dose of 100 mg once daily.

Intervention Type DRUG

Warfarin

Anticoagulation therapy was initiated on the second day after surgery, starting at 4.5 mg once nightly, with adjustments made based on changes in the INR value.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Individuals aged 18 years and above, but not exceeding 85 years;
* Patients who have successfully undergone mitral valve plasty with implantation of a mitral annuloplasty ring, with the option to undergo concurrent tricuspid valve plasty, atrial septal defect repair, or myxoma resection;
* Patients with preoperative electrocardiogram (ECG) showing sinus rhythm;
* Alternatively, patients with preoperative ECG showing atrial fibrillation (AF) rhythm, but who are male with a CHA2DS2-VASc-60 score of 0 or female with a score of 1; for patients with a CHA2DS2-VASc-60 score exceeding the aforementioned values but who have successfully converted to sinus rhythm following concurrent radiofrequency catheter ablation for AF;
* Patients who voluntarily participate in this study, have signed a written informed consent form, and are willing to comply with follow-up procedures.

Exclusion Criteria

* Patients with contraindications to any of the following medications: heparin, warfarin, or aspirin;
* Patients who have undergone artificial valve replacement at other valve positions;
* Patients with a high risk of bleeding (including active bleeding, platelet count \<50×10\^9/L, hemoglobin \<8.0 g/dL, history of cerebral hemorrhage, active peptic ulcer, or history of gastrointestinal bleeding within the last 3 months);
* Patients with acute coronary syndrome within the last month;
* Patients with symptomatic stroke within the last 3 months;
* Patients with renal insufficiency and a creatinine clearance rate \<30 mL/min; Dialysis patients;
* Patients with moderate or severe hepatic impairment or liver disease with coagulation dysfunction: Child-Pugh score greater than B or bilirubin greater than or equal to 2 times the upper limit of normal (ULN) as defined by the center, and alanine aminotransferase (ALT), aspartate aminotransferase (AST), or serum alkaline phosphatase (ALP) levels greater than or equal to 3 times the ULN as defined by the center;
* Patients with active malignant tumors;
* Patients who are planned to undergo surgical intervention or treatment (including endoscopy) during the trial period that requires discontinuation of anticoagulants;
* Pregnant or lactating women, or fertile individuals unwilling or unable to use effective contraceptives;
* Patients who have participated in any drug clinical trial within the last 6 months prior to screening;
* Patients who refuse to undergo follow-up;
* Patients deemed unsuitable for participation in this study by the investigator.
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Guangdong Provincial People's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Guangdong Provincial People's Hospital

Guangzhou, Guangdong, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Huanlei Huang Phd

Role: CONTACT

Phone: 765-714-9765

Email: [email protected]

Shanwen Pang BD

Role: CONTACT

Email: [email protected]

Facility Contacts

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Huanlei Huang Phd

Role: primary

Shanwen Pang BD

Role: backup

Other Identifiers

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KY2024-767-02

Identifier Type: -

Identifier Source: org_study_id