{
  "abstract": "BACKGROUND: The benefits of adding aspirin to warfarin and warfarin treatment intensity for Japanese patients with mechanical valve replacement (MeVR) are unclear. METHODS AND RESULTS: This multicenter non-randomized observational study recruited 158 Japanese patients who underwent MeVR in 11 university hospitals in Kyushu and Okinawa; 74 patients were allocated to the warfarin (W) group and 84 were allocated to the warfarin plus aspirin (W+A) group. Patients were followed for a mean (±SD) of 5.0±1.9 years. The primary and secondary endpoints were mainly atherosclerotic/thrombotic and bleeding events, respectively. There was no difference in the incidence of the primary endpoint between the W and W+A groups (14% vs. 22%, respectively; P=0.13). Univariate analysis revealed a higher incidence of the secondary endpoint in the W+A than W group (35% vs. 22%; P=0.032), but the difference was not significant in multivariate analysis. For the entire cohort, the postoperative mean international normalized ratio of prothrombin time (PT-INR) was relatively low (2.1±0.3). There were no differences in the incidence of events between PT-INR <2.0 and 2.0-3.0 (primary endpoint: 21% vs. 16%, respectively [P=0.41]; secondary endpoints: 33% vs. 26%, respectively [P=0.19]). CONCLUSIONS: Adding aspirin to warfarin treatment was not superior to warfarin alone, and relatively weak warfarin treatment (PT-INR <2.0) was not necessarily associated with an increased number of events (vs. PT-INR 2.0-3.0) in Japanese patients who underwent MeVR.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 38,
  "authors": [
    {
      "name": "Yuki Tsuda"
    },
    {
      "name": "Koichi Arinaga"
    },
    {
      "name": "Takashi Shuto"
    },
    {
      "name": "Hiromichi Sonoda"
    },
    {
      "name": "Kazuhisa Matsumoto"
    },
    {
      "name": "Shuhei Sakaguchi"
    },
    {
      "name": "Go Kuwahara"
    },
    {
      "name": "Masataka Eto"
    },
    {
      "name": "Jun Takaki"
    },
    {
      "name": "Hitoshi Inafuku"
    },
    {
      "name": "Masanori Takamatsu"
    },
    {
      "name": "Ichiro Matsumaru"
    },
    {
      "name": "Kazuyoshi Takagi"
    },
    {
      "name": "Takayuki Kawashima"
    },
    {
      "name": "Tomoki Ushijima"
    },
    {
      "name": "Hideaki Kanda"
    },
    {
      "name": "Kunihide Nakamura"
    },
    {
      "name": "Hiromitsu Teratani"
    },
    {
      "name": "Toru Yasutsune"
    },
    {
      "name": "Takashi Yoshinaga"
    },
    {
      "name": "Yuya Kise"
    },
    {
      "name": "Hiroyuki Morokuma"
    },
    {
      "name": "Kiyoyuki Eishi"
    },
    {
      "name": "Takashi Miura"
    },
    {
      "name": "Keiji Kamohara"
    },
    {
      "name": "Kojiro Furukawa"
    },
    {
      "name": "Toshihiro Fukui"
    },
    {
      "name": "Yosuke Nishimura"
    },
    {
      "name": "Hideichi Wada"
    },
    {
      "name": "Koji Furukawa"
    },
    {
      "name": "Yoshiharu Soga"
    },
    {
      "name": "Akira Shiose"
    },
    {
      "name": "Shinji Miyamoto"
    },
    {
      "name": "Eiki Tayama"
    },
    {
      "name": "Yoshihisa Fujino"
    },
    {
      "name": "Yutaka Otsuji"
    },
    {
      "name": "Masaharu Kataoka"
    },
    {
      "name": "on behalf of the ASPIRIN-Trial Investigators"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9c5wre0wknykw.bib",
  "cited_by": 2,
  "doi": "10.1253/circj.cj-25-0460",
  "fulltext_url": "https://www.jstage.jst.go.jp/article/circj/90/9/90_CJ-25-0460/_article",
  "id": "9c5wre0wknykw",
  "issns": [
    "1347-4820",
    "1346-9843"
  ],
  "landing_url": "https://www.jstage.jst.go.jp/article/circj/90/9/90_CJ-25-0460/_article",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "jstage-journal",
      "medicine/cardiovascular"
    ],
    [
      "openalex",
      "2705|Cardiac Valve Diseases and Treatments"
    ]
  ],
  "openalex": "W7126201413",
  "pdf_url": "https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-25-0460/_pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-25",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/9c5wre0wknykw.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:24Z",
      "native_id": "10.1253/circj.cj-25-0460",
      "source": "jstage",
      "url": "https://www.jstage.jst.go.jp/article/circj/90/9/90_CJ-25-0460/_article"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiac Valve Diseases and Treatments",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Combined Aspirin Study for Mechanical Prosthetic Valve in Kyushu and Ryukyu by Inter-University Hospital Network (ASPIRIN-Trial)",
  "title_text": "Combined Aspirin Study for Mechanical Prosthetic Valve in Kyushu and Ryukyu by Inter-University Hospital Network (ASPIRIN-Trial)",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:24Z",
  "url": "https://research.draconitic.com/paper/9c5wre0wknykw",
  "venue": "Circulation Journal",
  "versions": []
}