Anticoagulation After Valve Replacement: A Multicenter Retrospective Study

Kudo, Tatsuhiko; Kawase, M; Kawada, Shiaki; Kurosawa, Hiromi; Koyanagi, Hitoshi; Takeuchi, Yasuo; Hosoda, Yasuhiro; Wanibuchi, Y

doi:10.1046/j.1525-1594.1999.06110.x

Cited by 8 publications

(7 citation statements)

References 10 publications

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“…You et al [8] reported that INR of 1.8-2.4 appeared to be associated with the lowest incidence rate of major bleeding or thromboembolic events in a cohort of Hong Kong Chinese patients receiving warfarin therapy for moderateintensity anticoagulation. However, Tatsuhiko et al [9] reported thromboembolism in 71% of patients and bleeding complications in 47% patients on INR ranging from 1.6 to 2.8.…”

Section: Discussionmentioning

confidence: 99%

Low-Intensity International Normalized Ratio (INR) Oral Anticoagulant Therapy in Chinese Patients with Mechanical Heart Valve Prostheses

Zhang

Liu

et al. 2011

Cell Biochem Biophys

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The purpose of this study was to define the optimal international normalized ratio (INR) intensity of oral anticoagulant therapy in Chinese patients with valve replacement surgery. We studied 1,658 patients who underwent mechanical valve replacement in Beijing Anzhen Hospital; the focus of the study was on correlation between intensity of anticoagulant therapy and thromboembolism/hemorrhage complications. We further followed up 1,508 patients for 46 ± 16 months (range 1-61 months). Average INR was 2.13 ± 0.56, and warfarin dose was 3.09 ± 0.85 mg/day. The incidence rate of anticoagulation-related thromboembolism was 1.17 per 100 patient-years (%/pt-y), and the incidence rate of anticoagulation-related hemorrhage was 2.02%/pt-y. The incidence rate of total complications (i.e., combined thromboembolism and hemorrhages) was 3.24%/pt-y. The rate of total complications in group on INR 1.3-2.3 (aortic valve replacement: 1.3-1.8; mitral valve replacement and double valve replacement: 1.8-2.3) was the lowest among all anticoagulant therapy regimens followed. In conclusion, the relatively low anticoagulant strategy presented above efficiently prevents thrombosis and hemorrhage complications.

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Section: Discussionmentioning

confidence: 99%

Low-Intensity International Normalized Ratio (INR) Oral Anticoagulant Therapy in Chinese Patients with Mechanical Heart Valve Prostheses

Zhang

Liu

et al. 2011

Cell Biochem Biophys

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“…7 Asians seem to be less vulnerable to thrombotic diseases than Caucasians. The incidence of thromboembolism is low in Japan, despite the less intensive regimen; 2,3,8 however, guidelines for the optimal therapeutic range do not exist in Japan. Kitamura et al recommend an optimum range for the INR between 1.2 and 3.0 in patients with a low risk of thromboembolism, and between 2.0 and 3.0 in high-risk patients.…”

Section: Discussionmentioning

confidence: 99%

Anticoagulant Therapy in Japanese Patients With Mechanical Mitral Valves.

Matsuyama

Matsumoto

Sugita

et al. 2002

Circ J

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There are no guidelines for the optimal therapeutic range of anticoagulant therapy in Japanese patients with mechanical heart valves. A total of 214 patients were followed retrospectively after mitral mechanical valve replacement (mean duration of follow-up, 4.8 years; total duration of follow-up, 1,027 patient-years). The target range of the international normalized ratio (INR) for oral anticoagulation was between 1.5 and 2.5. For all patients 10,416 measurements of the INR were obtained during the follow-up period and approximately 76% of the intensity measurements were within the target range. Thromboembolism occurred in 8 patients (0.8 per 100 patient-years) and major bleeding in 5 patients (0.5 per 100 patient-years). There was no correlation between the distribution of the INR and the occurrence of thromboembolic or bleeding complications. In the univariate analysis of the various risk factors, patients who had a tilting valve or did not receive antiplatelet therapy had an increased risk of thromboembolism. However, there were no risk factors with respect to bleeding complications. A target range of 1.5 to 2.5 INR appears to be the optimal range and is safe for thromboembolism or bleeding complications. Thromboembolism may be reduced by additional antiplatelet therapy, and a tilting valve needs more intense anticoagulation. (Circ J 2002; 66: 668 -670)

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“…For example, low‐intensity anticoagulation is suggested to most Asian patients because they would suffer higher frequency of bleeding than their Caucasian counterparts . However, some Asian patients may need high‐intensity anticoagulation due to several thrombophilia factors . These potential risks cannot be identified by INR test alone; therefore, supplemental markers are needed to improve individualized anticoagulation.…”

Section: Use Of D‐dimer In Oral Anticoagulation Therapymentioning

confidence: 99%

“…44,48 However, some Asian patients may need high-intensity anticoagulation due to several thrombophilia factors. 4,49 These potential risks cannot be identified by INR test alone; therefore, supplemental markers are needed to improve individualized anticoagulation. D-dimers can screen out patients with inadequate anticoagulation.…”

Section: Use Of D-dimer To Guide the Optimal Intensity Of Anticoagumentioning

confidence: 99%

Use of D‐dimer in oral anticoagulation therapy

Zhang

Long

Xiao

et al. 2018

Int J Lab Hematology

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Individualized anticoagulation management and improvement of the safety and effectiveness of oral anticoagulant have always been the focus of clinicians' attention. D‐dimer, a sensitive marker of thrombosis and coagulation activation, is not only traditionally used in the diagnosis of venous thromboembolism, acute aortic dissection, and disseminated intravascular coagulation but can also be used as a helpful marker in the management of oral anticoagulant, including evaluating the anticoagulation quality, predicting clinical outcomes, and determining the optimal duration and intensity of anticoagulation.

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Anticoagulation After Valve Replacement: A Multicenter Retrospective Study

Cited by 8 publications

References 10 publications

Low-Intensity International Normalized Ratio (INR) Oral Anticoagulant Therapy in Chinese Patients with Mechanical Heart Valve Prostheses

Low-Intensity International Normalized Ratio (INR) Oral Anticoagulant Therapy in Chinese Patients with Mechanical Heart Valve Prostheses

Anticoagulant Therapy in Japanese Patients With Mechanical Mitral Valves.

Use of D‐dimer in oral anticoagulation therapy

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