Inappropriate anticoagulation of patients with a mechanical heart valve

NHS England have issued a safety alert on the risk of inappropriate anticoagulation of patients with a mechanical heart valve.

Published guidance supported clinical teams in reviewing patients being treated with a vitamin K antagonist (VKA) early on in the pandemic and change their medication to an alternative anticoagulant where needed. 

However, there have been reports that those with a mechanical heart valve have been prescribed a molecular weight heparin (LMWH) or a direct oral anticoagulant (DOAC) which the guidance lists as an exception to its use in such patients.  

The alert asks GPs and other NHS providers to urgently identify patients with a mechanical heart valve and ensure they are on the most appropriate anticoagulant. 

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Source: NHS England, 14 July 2021