title: Low-dose anticoagulation in Chinese patients with mechanical heart valves.
abstract: The aim of this study was to provide guidelines for optimal anticoagulation in Chinese patients after mechanical heart valve replacement. A Carbomedics valve was implanted in 178 patients between July 2000 and July 2003. During follow-up, 22 bleeding events and 1 thromboembolic complication occurred. The linearized rates of bleeding and thromboembolism were 5.83% and 0.26% per patient-year, respectively. The linearized mortality rate was 0.79% per patient-year. The final mean international normalized ratio (INR) was 1.68+/-0.38, however there was a significant variation between the early and late periods of follow-up. For Chinese patients with mechanical heart valves, bleeding was the major complication rather than thromboembolism. Low-dose anticoagulation (international normalized ratio 1.4-2.0) could markedly decrease bleeding and effectively prevent thromboembolism. As the INR was most unstable in the first postoperative month, re-examination of patients in this period is critical.
authors.affiliation: Department of Cardiovascular Surgery, The Second Xiang-Ya Hospital of Central South University, Changsha, Hunan 410011, China. Mark037100@163.com
authors.forename: Xin-Min
authors.initials: XM
authors.lastname: Zhou
authors.forename: Wei
authors.initials: W
authors.lastname: Zhuang
authors.forename: Jian-Guo
authors.initials: JG
authors.lastname: Hu
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Li
authors.forename: Jie-Feng
authors.initials: JF
authors.lastname: Yu
authors.forename: Ling
authors.initials: L
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery; D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass; D002681:China / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000097:blood / Q000628:therapy; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D011474:Prosthesis Design; D011517:Prothrombin Time; D016019:Survival Analysis; D013923:Thromboembolism / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D016896:Treatment Outcome; D014859:Warfarin / Q000008:administration & dosage
chemical_list: D000925:Anticoagulants; D015415:Biomarkers; D014859:Warfarin