Determinants of low‐quality warfarin anticoagulation in patients with mechanical prosthetic heart valves. The nationwide PLECTRUM study
Key result
In patients with mechanical prosthetic heart valves on warfarin, 48.5% had a suboptimal time in therapeutic range (<60%), strongly associated with higher target INR ranges (OR 8.215 for 3.0-4.0).
Why the study?
Quality of warfarin therapy in patients with a mechanical prosthetic heart valve had been barely investigated.
What are the clinical determinants of low time in the therapeutic range (TiTR <60%) in patients with mechanical prosthetic heart valves receiving warfarin?
Population
2111 patients with MPHVs from the nationwide PLECTRUM study
Design
Nationwide observational study
Authors
Discussion
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Member takes
Implication
Suboptimal TTR in mechanical valve patients warrants closer INR monitoring with higher targets; extends predictors of poor control and leaves open alternative strategies.
Study Design
Type
Observational (n=2,111)
Multicenter
Yes
Structured PICO
What are the clinical determinants of low time in the therapeutic range (TiTR <60%) in patients with mechanical prosthetic heart valves receiving warfarin?
P
Population
2,111 patients with mechanical prosthetic heart valves (MPHVs) from the nationwide PLECTRUM study by the Italian Federation of Anticoagulation Clinics
I
Intervention
Warfarin therapy
O
Outcome
Low time in the therapeutic range (TiTR <60%)surrogate
Nearly half of patients with mechanical prosthetic heart valves have suboptimal warfarin anticoagulation (TiTR <60%), with higher target INR ranges and comorbidities like diabetes and hypertension being significant predictors of poor control.
Cite This Study
Pastori et al. (2020) conducted an observational in Mechanical prosthetic heart valves (n=2,111). Warfarin was evaluated on Low time in the therapeutic range (TiTR <60%). In patients with mechanical prosthetic heart valves on warfarin, 48.5% had a suboptimal time in therapeutic range (<60%), strongly associated with higher target INR ranges (OR 8.215 for 3.0-4.0).