Background: Patients with prosthetic heart valves are at increased risk for valve thrombosis and arterial thromboembolism. Oral anticoagulation alone, or the addition of antiplatelet drugs, has been used to minimise this risk. An important issue is the effectiveness and safety of adding single antiplatelet. Objectives: To further assess the safety and efficacy of combined oral anticoagulant and antiplatelet therapy versus oral anticoagulant monotherapy in patients with prosthetic heart valves regarding prosthetic valve thrombosis. Method: In last 10 years around 870 patients underwent mitral and aortic valve replacement on monotherapy. In last 3 year data around 60 patients presented with prosthetic valve thrombosis who were on anticoagulation alone. Most of patients were those who underwent mitral valve replacement out of which 90 % were female patients. From last one year onward 60 patients were put on low dose antiplatelets75 mg plus anticoagulant, out of which till now no patient presented with valve thrombosis. Results: Adding low daily dose of aspirin 75mg reduce the incidence of prosthetic valve thrombosis and thromboembolism as is already proven in many studies. Similar results were observed in our study. But its too early to conclude, as duration is only one year, so it need further evaluation to reach end point. Conclusion: Adding antiplatelet therapy, either dipyridamole or low-dose aspirin, to oral anticoagulation decreases the risk of systemic embolism or death among patients with prosthetic heart valves. The risk of major bleeding is decreased with antiplatelet therapy by having lower target INR value (2.5). These results apply to patients with mechanical prosthetic valves or those with biological valves and indicators of high risk such as atrial fibrillation or prior thromboembolic events. The effectiveness and safety of low-dose aspirin (75 mg daily) appears to be similar to higher-dose aspirin and dipyridamole. So consideration should be given to it for patient benefit.
