title: Anticoagulation therapy with combined low dose aspirin and warfarin following mechanical heart valve replacement.
abstract: BACKGROUND
  This study was designed to evaluate safety and efficacy of combined low dose aspirin and warfarin therapy following mechanical heart valve replacement.
  
  
  METHODS
  A total of 1496 patients (686 males, mean age 35±8.5 years) undergoing mechanical heart valvular replacement were randomly divided into study (warfarin plus 75-100 mg aspirin) or control (warfarin only) group. International normalized ratio (INR) and prothrombin time was maintained at 1.8-2.5 and 1.5-2.0 times of the normal value, respectively. Thromboembolic events and major bleedings were registered during follow up.
  
  
  RESULTS
  Patients were followed up for 24±9 months. The average dose of warfarin in the study and control group was 2.92±0.87 mg and 2.89±0.79 mg, respectively (p>0.05). The overall thromboembolic events in study group were lower than in control group (2.1% vs. 3.6%, p=0.044). No statistically significant differences were found in hemorrhage events (3.5% vs. 3.7%, p>0.05) or mortality (0.3% vs 0.4%, p>0.05) between the two groups.
  
  
  CONCLUSIONS
  Following mechanical valve replacement, combined low dose aspirin and warfarin therapy was associated with a greater reduction in thromboembolism events than warfarin therapy alone. This combined treatment was not associated with an increase in the rate of major bleeding or mortality.
authors.affiliation: Department of Cardiac Surgery, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong, 252000, P.R. China.
authors.forename: Ming-Feng
authors.initials: MF
authors.lastname: Dong
authors.forename: Zeng-Shan
authors.initials: ZS
authors.lastname: Ma
authors.forename: Sheng-Jun
authors.initials: SJ
authors.lastname: Ma
authors.forename: Shou-Dong
authors.initials: SD
authors.lastname: Chai
authors.forename: Pei-Zhe
authors.initials: PZ
authors.lastname: Tang
authors.forename: Dao-Kuo
authors.initials: DK
authors.lastname: Yao
authors.forename: Le-Xin
authors.initials: LX
authors.lastname: Wang
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006470:Hemorrhage / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D011517:Prothrombin Time; D013923:Thromboembolism / Q000188:drug therapy / Q000517:prevention & control; D016896:Treatment Outcome; D014859:Warfarin / Q000008:administration & dosage / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D001241:Aspirin