RE-ALIGN: First trial of novel oral anticoagulant in patients with mechanical heart valves – The search continues

[first paragraph of article] Over 4 million people worldwide have received a prosthetic heart valve, and an estimated 300,000 valves are being implanted every year.  Prosthetic heart valves improve quality of life and survival of patients with severe valvular heart disease, but the need for antithrombotic therapy to prevent thromboembolic complications in valve recipients, poses challenges for clinicians and patients. Post-operative oral vitamin K antagonists, such as warfarin, are prescribed universally. Some disadvantages of warfarin are its narrow therapeutic range, pharmacological and food interactions, and the need for frequent monitoring and dose adjustments. New generation anticoagulants are more pharmacologically stable and do not require monitoring, although they have not been used as yet for the management of prosthetic heart valves.