title: Anticoagulation after coronary artery surgery in patients with polycythemia vera: report of two cases.
abstract: Polycythemia vera is a myeloproliferative disorder associated with the thromboembolic events. Normalization of the hematocrit and elevated platelet counts is obligatory to reduce the thrombotic risk of patients with PV. Therapeutic strategies include phlebotomy, myelosuppressive agents, and, more recently, interferon-alpha. In addition, appropriate antiplatelet therapy should be administered to prevent life-threatening complications and reducing the viscosity of the blood. Although aspirin is widely preferred in such patients, this monodrug therapy or combined with clopidogrel as an alternative approach might not be enough, especially after coronary artery surgery. Therefore, warfarin should be added to anticoagulant therapy. This short report describes the use of warfarin, associated with aspirin and clopidogrel as an anticoagulant regimen after coronary artery bypass surgery in two cases with polycythemia vera. We believe that a combination of warfarin with other oral antiplatelet agents may be more effective in preventing the coronary artery bypass graft thrombosis.
authors.affiliation: Department of Cardiovascular Surgery, Gulhane Military Medicine School, Ankara, Turkey.
authors.forename: Bilgehan Savaş
authors.initials: BS
authors.lastname: Oz
authors.forename: Fatih
authors.initials: F
authors.lastname: Asgun
authors.forename: Hakki Tankut
authors.initials: HT
authors.lastname: Akay
authors.forename: Erkan
authors.initials: E
authors.lastname: Kaya
authors.forename: Erkan
authors.initials: E
authors.lastname: Kuralay
authors.forename: Harun
authors.initials: H
authors.lastname: Tatar
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011087:Polycythemia Vera / Q000503:physiopathology*; D011184:Postoperative Period; D013923:Thromboembolism / Q000517:prevention & control*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D013997:Time Factors; D014859:Warfarin / Q000627:therapeutic use