| Anticoagulant therapy in Japanese patients with mechanical mitral valves. | |
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MedLine Citation:
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PMID: 12135136 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Katsuhiko Matsuyama; Masahiko Matsumoto; Takaaki Sugita; Junichiro Nishizawa; Kazunori Yoshida; Yoshiyuki Tokuda; Takehiko Matsuo |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Circulation journal : official journal of the Japanese Circulation Society Volume: 66 ISSN: 1346-9843 ISO Abbreviation: Circ. J. Publication Date: 2002 Jul |
Date Detail:
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Created Date: 2002-07-23 Completed Date: 2003-06-03 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 101137683 Medline TA: Circ J Country: Japan |
Other Details:
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Languages: eng Pagination: 668-70 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Surgery, Tenri Hospital, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Analysis of Variance Anticoagulants / pharmacology, therapeutic use* Female Heart Valve Prosthesis / adverse effects* Hemorrhage / etiology, prevention & control Humans Incidence Japan Male Middle Aged Mitral Valve Retrospective Studies Risk Factors Thromboembolism / etiology, prevention & control |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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