[Anticoagulation in chinese patients with carbomedics mechanical prosthetic heart valves].
OBJECTIVE
To provide some references for defining the Chinese optimal intensity of anticoagulation after mechanical heart valve prostheses replacement.


METHODS
For the 178 patients with carbomedics mechanical prosthetic heart valves, the means of INR were compared between the patients with complications and those without complications at the standard of INR1. 4 - 2.0. Also, the variations of INR were compared among different follow-ups.


RESULTS
During the follow-up, 22 hemorrhagic and 1 thromboembolic complication occurred. The total linearized rate of anticoagulation-related hemorrhage was 5.83% pty. The total linearized rate thromboembolism was 0.26% pty. The late mortality was 0.79% pty (3 cases ). The final mean INR was 1.68 +/- 0.38. The final mean oral warfarin dose was 2.34 +/- 0.80 mg. The differences of variations of INR in five periods were significant (F = 5.072, P < 0.05). The mean INR in the first month of follow-up was 1.75 +/- 0.27.


CONCLUSIONS
For Chinese patients with mechanical prosthetic heart valve, hemorrhage is the principal complication, the ratio of which is much higher than that of thromboembolism. The low-dose anticoagulation (INR1. 4-2.0) could remarkably decrease hemorrhagic events as effectively as prevent the thrombolic events. Moreover the INR is the most unstable in the first month of follow-up, so re-examination for the patients in the first month after the operation is vitally important.
Zhuang
Wei
W
Department of Cardiothoracic Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China. zhuangwei1005@163.com
Zhou
Xin-Min
XM
Hu
Jian-Guo
JG
Li
Jian-Min
JM
Yu
Jie-Feng
JF
Jiang
Ling
L
Hu
Dong-Xu
DX
D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage*; D001021:Aortic Valve / Q000601:surgery; D002315:Cardiopulmonary Bypass; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000097:blood / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control*; D011184:Postoperative Period; D014859:Warfarin / Q000008:administration & dosage
D000925:Anticoagulants; D014859:Warfarin; D006493:Heparin