Document Detail

Anticoagulant therapy in Japanese patients with mechanical mitral valves.
MedLine Citation:
PMID:  12135136     Owner:  NLM     Status:  MEDLINE    
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.
Katsuhiko Matsuyama; Masahiko Matsumoto; Takaaki Sugita; Junichiro Nishizawa; Kazunori Yoshida; Yoshiyuki Tokuda; Takehiko Matsuo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  2002-07-23     Completed Date:  2003-06-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  668-70     Citation Subset:  IM    
Department of Cardiovascular Surgery, Tenri Hospital, Japan.
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MeSH Terms
Aged, 80 and over
Analysis of Variance
Anticoagulants / pharmacology,  therapeutic use*
Heart Valve Prosthesis / adverse effects*
Hemorrhage / etiology,  prevention & control
Middle Aged
Mitral Valve
Retrospective Studies
Risk Factors
Thromboembolism / etiology,  prevention & control
Reg. No./Substance:

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