Anticoagulation therapy with combined low dose aspirin and warfarin following mechanical heart valve replacement

Abstract Background: For patients with heart valve replacement, self-management can play an important role in controlling the patient's condition, therefore, the purpose of this review was to identify the aspects of self-management and its clinical outcomes in patients with heart valve replacement. Methods: We conducted a systematic review of peer-reviewed research literature focused on self-management in patients with heart valve replacement. The databases of PubMed, Scopus, and web of science were searched until May 2020 free from time and language limitation. Al documents were assessed for eligible articles by title or abstract according to the search strategy.The screening process of articles was conducted by two independent authors. The selected articles were checked regarding to inclusion and exclusion criteria.Results: Finally, 25 studies were considered in this systematic review. Self-management of these patients has prerequisites and requires appropriate training. Self-management in these patients is applicable in the aspects of Anticoagulation therapy self-management, INR self-testing, Low-dose INR Self-management, and Heart valve function self-monitoring. In this method, with better control of INR levels and Anticoagulation therapy, the incidence of complications will be reduced and patients will be able to diagnose functional disorders in the early stages by monitoring the function of valve, which will prevent the progression of complications. Conclusion: The results of this review clearing that self-management is applicable in the aspects of Anticoagulation therapy, INR control, low dose INR management, and monitoring of cardiac valve function and by improving care standards, it will improve the quality of treatment for these patients.

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D-Dimer to Predict the Clinical Outcomes in Patients with Mechanical Heart Valve Replacement During Oral Anticoagulation Therapy

International Heart Journal ◽

10.1536/ihj.18-237 ◽

2019 ◽

Vol 60 (3) ◽

pp. 631-636

Author(s):

Litao Zhang ◽

Yanli Long ◽

Hongyan Xiao ◽

Jun Yang ◽

Xiaohui Liu ◽

...

Keyword(s):

Clinical Outcomes ◽

Valve Replacement ◽

Heart Valve ◽

Oral Anticoagulation ◽

Anticoagulation Therapy ◽

Mechanical Heart Valve ◽

Heart Valve Replacement ◽

Oral Anticoagulation Therapy ◽

D Dimer

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Self-Management of Oral Anticoagulation Therapy Improves Long-Term Survival in Patients With Mechanical Heart Valve Replacement

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2006.08.036 ◽

2007 ◽

Vol 83 (1) ◽

pp. 24-29 ◽

Cited By ~ 39

Author(s):

Heinrich Koertke ◽

Armin Zittermann ◽

Otto Wagner ◽

Reiner Koerfer

Keyword(s):

Valve Replacement ◽

Heart Valve ◽

Oral Anticoagulation ◽

Anticoagulation Therapy ◽

Mechanical Heart Valve ◽

Heart Valve Replacement ◽

Self Management ◽

Term Survival ◽

Oral Anticoagulation Therapy

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Abstract 17101: Low-intensity Anticoagulant Treatment in Chinese Patients with Mechanical Heart Valve Prostheses: Early Outcomes of a Prospective, Multicenter Registry in China

Circulation ◽

10.1161/circ.130.suppl_2.17101 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

JIA HU ◽

BO FU ◽

Jian-ping Xu ◽

Ying-kang Shi ◽

Li Dong

Keyword(s):

Valve Replacement ◽

Heart Valve ◽

Heart Valves ◽

Anticoagulation Therapy ◽

Mechanical Heart Valve ◽

Heart Valve Replacement ◽

Chinese Patients ◽

Anticoagulant Treatment ◽

Low Intensity

Background: Current guidelines recommend vitamin K antagonist treatment with relatively higher international normalized ratio (INR) targets for patients with mechanical heart valve prostheses. However, there is lack of data from large clinical trials about the outcomes of low-intensity anticoagulant treatment in Chinese patients with mechanical heart valves. Methods: The Low-intensity Anticoagulation Therapy after Heart Valve Replacement is an ongoing multicenter, prospective, observational cohort study (ChiCTR-OCH-10001185). Between January 2011 and August 2013, qualified patients from 34 cardiac centers in China mainland were recruited in the Anticoagulation Therapy Database of Chinese Patients after Heart Valve Replacement. Baseline characteristics were collected and patients were followed up for anticoagulant treatment, INRs and adverse events till March 2014. Results: The database recruited 11,769 patients, and 11,040 patients (93.8%) undergoing mechanical heart valve replacement were analyzed in this study. The mean age was 48.9±11.5 years and 6,227 patients (56.4%) were female. A total of 9,870 patients (89.4%) of the baseline population completed at least 6 months follow-up. The median follow-up time was 1.2 years (range 0.5-2.2). For all 9,870 patients, 143,115 measurements of the INR were obtained. The average warfarin dosage was 2.98±1.16mg/d and the mean INR was 1.81±0.46, and 88.7% patients had an INR level≤2.5 during the follow-up period. The incidence of hemorrhagic events was the lowest in patients with an INR≤2.0, whereas the risk of thromboembolic complications in this group of patients was not significantly increased (Table 1). Conclusions: Low-intensity anticoagulation with an INR of 1.5 to 2.5 is safe and effective for Chinese patients with mechanical heart valves in short-term. The optimal INR targets for mechanical valve recipients with different implanting positions and risk factors require further investigation.

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