Reduced anticoagulation after mechanical aortic valve replacement: Interim results from the Prospective Randomized On-X Valve Anticoagulation Clinical Trial randomized Food and Drug Administration investigational device exemption trial

The PROACT trial is evaluating the clinical utility and safety of less aggressive anticoagulation schemes after bileaflet AVR. This arm of the trial compared low dose (INR 1.5-2.0) to standard dose (INR 2.0-3.0)warfarin. At an average follow-up of nearly 4 years, the low dose group experienced significantly fewer bleeding complications but had similar rates of neurologic events and all-cause mortality.