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Combined Aspirin Study for Mechanical Prosthetic Valve in Kyushu and Ryukyu by Inter-University Hospital Network (ASPIRIN-Trial)
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- Tsuda Yuki
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
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- Arinaga Koichi
- Department of Cardiovascular Surgery, Kurume University, School of Medicine
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- Shuto Takashi
- Department of Cardiovascular Surgery, Faculty of Medicine, Oita University
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- Sonoda Hiromichi
- Department of Cardiovascular Surgery, Kyushu University Graduate School of Medicine
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- Matsumoto Kazuhisa
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University
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- Sakaguchi Shuhei
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Miyazaki
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- Kuwahara Go
- Department of Cardiovascular Surgery, Faculty of Medicine, Fukuoka University
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- Eto Masataka
- Department of Cardiovascular Surgery, University of Occupational and Environmental Health, School of Medicine
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- Takaki Jun
- Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kumamoto University
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- Inafuku Hitoshi
- Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, University of the Ryukyus
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- Takamatsu Masanori
- Department of Thoracic and Cardiovascular Surgery, Saga University, School of Medicine
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- Matsumaru Ichiro
- Department of Cardiovascular Surgery, Graduate School of Biomedical Sciences, Nagasaki University
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- Takagi Kazuyoshi
- Department of Cardiovascular Surgery, Kurume University, School of Medicine
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- Kawashima Takayuki
- Department of Cardiovascular Surgery, Faculty of Medicine, Oita University
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- Ushijima Tomoki
- Department of Cardiovascular Surgery, Kyushu University Graduate School of Medicine
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- Kanda Hideaki
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University
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- Nakamura Kunihide
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Miyazaki
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- Teratani Hiromitsu
- Department of Cardiovascular Surgery, Faculty of Medicine, Fukuoka University
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- Yasutsune Toru
- Department of Cardiovascular Surgery, University of Occupational and Environmental Health, School of Medicine
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- Yoshinaga Takashi
- Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kumamoto University
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- Kise Yuya
- Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, University of the Ryukyus
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- Morokuma Hiroyuki
- Department of Thoracic and Cardiovascular Surgery, Saga University, School of Medicine
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- Eishi Kiyoyuki
- Department of Cardiovascular Surgery, Graduate School of Biomedical Sciences, Nagasaki University
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- Miura Takashi
- Department of Cardiovascular Surgery, Graduate School of Biomedical Sciences, Nagasaki University
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- Kamohara Keiji
- Department of Thoracic and Cardiovascular Surgery, Saga University, School of Medicine
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- Furukawa Kojiro
- Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, University of the Ryukyus
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- Fukui Toshihiro
- Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kumamoto University
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- Nishimura Yosuke
- Department of Cardiovascular Surgery, University of Occupational and Environmental Health, School of Medicine
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- Wada Hideichi
- Department of Cardiovascular Surgery, Faculty of Medicine, Fukuoka University
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- Furukawa Koji
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Miyazaki
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- Soga Yoshiharu
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University
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- Shiose Akira
- Department of Cardiovascular Surgery, Kyushu University Graduate School of Medicine
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- Miyamoto Shinji
- Department of Cardiovascular Surgery, Faculty of Medicine, Oita University
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- Tayama Eiki
- Department of Cardiovascular Surgery, Kurume University, School of Medicine
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- Fujino Yoshihisa
- Department of Environmental Epidemiology, University of Occupational and Environmental Health, School of Medicine
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- Otsuji Yutaka
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
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- Kataoka Masaharu
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
Bibliographic Information
- Published
- 2026-01-31
- Resource Type
- journal article
- Version
- 1
- DOI
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- 10.1253/circj.cj-25-0460
- Publisher
- The Japanese Circulation Society
Search this article
Description
<p>Background: The benefits of adding aspirin to warfarin and warfarin treatment intensity for Japanese patients with mechanical valve replacement (MeVR) are unclear.</p><p>Methods and Results: This multicenter non-randomized observational study recruited 158 Japanese patients who underwent MeVR in 11 university hospitals in Kyushu and Okinawa; 74 patients were allocated to the warfarin (W) group and 84 were allocated to the warfarin plus aspirin (W+A) group. Patients were followed for a mean (±SD) of 5.0±1.9 years. The primary and secondary endpoints were mainly atherosclerotic/thrombotic and bleeding events, respectively. There was no difference in the incidence of the primary endpoint between the W and W+A groups (14% vs. 22%, respectively; P=0.13). Univariate analysis revealed a higher incidence of the secondary endpoint in the W+A than W group (35% vs. 22%; P=0.032), but the difference was not significant in multivariate analysis. For the entire cohort, the postoperative mean international normalized ratio of prothrombin time (PT-INR) was relatively low (2.1±0.3). There were no differences in the incidence of events between PT-INR <2.0 and 2.0–3.0 (primary endpoint: 21% vs. 16%, respectively [P=0.41]; secondary endpoints: 33% vs. 26%, respectively [P=0.19]).</p><p>Conclusions: Adding aspirin to warfarin treatment was not superior to warfarin alone, and relatively weak warfarin treatment (PT-INR <2.0) was not necessarily associated with an increased number of events (vs. PT-INR 2.0–3.0) in Japanese patients who underwent MeVR.</p>
Journal
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- Circulation Journal
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Circulation Journal advpub (0), 2026-01-31
The Japanese Circulation Society
