Early in the Covid-19 pandemic, published guidance supported
clinical teams to review patients treated with a vitamin K antagonist (VKA) and
where appropriate change their medication to an alternative anticoagulant (eg a
low molecular weight heparin (LMWH) or a direct oral anticoagulant (DOAC)).
This was partly to reduce the frequency of clinic attendance for monitoring,
and thus reduce the risk to patients. The guidance listed exceptions where
specific patients should not be switched from a VKA, including patients with a
mechanical heart valve.
However, incidents have been reported of patients with a
mechanical heart valve being switched to a LMWH or a DOAC. This alert asks GPs
and other NHS providers of anticoagulation services to identify any patients
who have a record of a mechanical heart valve and are receiving a DOAC, and to
urgently review these patients to ensure they are on the most appropriate
anticoagulation therapy and monitoring.