[Significance of combined use of anticoagulants and antiplatelet agents in the early stage after prosthetic valve replacement].
Patients who had undergone prosthetic valve replacement were treated with warfarin (anticoagulant) alone or in combination of ticlopidine (200 mg/day) or aspirin (81 mg/day) (anti-platelet agents). The study of blood coagulation factors and platelet aggregation were carried out with these cases. 1) The patients (n = 24) receiving warfarin for 21 days after prosthetic valve replacement revealed marked increases in PIVKA-II and vitamin K1-epoxide. The protein C activity was significantly lower than that before the operation. High levels of more than 5 ng/ml of TAT were found before operation and after warfarin administration for 21 days. 2) Warfarin did not affect platelet aggregation, whereas ticlopidine inhibited ADP-induced platelet aggregation and aspirin inhibited both collagen-induced and arachidonic acid-induced aggregation. In conclusion, combined use of anticoagulants and antiplatelet agents after prosthetic valve replacement will suppress not only the blood coagulation but also the platelet aggregation systems.
Toyohira
H
H
Second Department of Surgery, Faculty of Medicine Kagoshima University, Japan.
Nakamura
K
K
Kariyazono
H
H
Yamada
K
K
Moriyama
Y
Y
Shimokawa
S
S
Saigenji
H
H
Taira
A
A
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage* / Q000494:pharmacology; D001241:Aspirin / Q000008:administration & dosage* / Q000494:pharmacology; D001777:Blood Coagulation / Q000187:drug effects; D003864:Depression, Chemical; D004359:Drug Therapy, Combination; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000494:pharmacology; D013927:Thrombosis / Q000517:prevention & control; D013988:Ticlopidine / Q000008:administration & dosage* / Q000494:pharmacology; D014859:Warfarin / Q000008:administration & dosage* / Q000494:pharmacology
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D013988:Ticlopidine; D001241:Aspirin