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February 18, 2009Current Opinion in Cardiology

International normalized ratio patient self-management for mechanical valves: is it safe enough?

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Why the study?

Does INR self-management reduce bleeding and thromboembolic complications in patients with mechanical heart valves?

Population

Patients with mechanical heart valve replacement requiring lifelong anticoagulation

Comparison

International normalized ratio self-management vs Conventional-dose INR self-management or…

Design

Review

Authors

RKReiner KöerferPennsylvania State UniversityNRNils ReissSchüchtermann-KlinikHKHeinrich KoertkeHeart and Diabetes Center North Rhine-Westphalia

Discussion

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Implication

Supports self-management in mechanical valve patients; extends observational data but leaves optimal dosing open pending RCTs.

Structured PICO

Does INR self-management reduce bleeding and thromboembolic complications in patients with mechanical heart valves?

P
Population
Patients with mechanical heart valve replacement requiring lifelong anticoagulation
I
Intervention
International normalized ratio (INR) self-management (self-testing and self-adjustment using a portable anticoagulation monitor)
C
Comparator
Conventional-dose INR self-management or standard care
O
Outcome
Complications such as bleeding and thromboembolismsafety

INR self-management is a safe and effective strategy for patients with mechanical heart valves, achieving low hemorrhagic complications without increasing thromboembolic risk.

Cite This Study

Köerfer et al. (2009) studied this question.

synapsesocial.com/papers/6a767f88f91c041860c44c07https://doi.org/10.1097/hco.0b013e328324e679

Topics

Anticoagulation in AF
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1INR Self-Management Permits Lower Anticoagulation Levels After Mechanical Heart Valve Replacement2003 · 101 citations
  2. 2Low-dose oral anticoagulation in patients with mechanical heart valve prostheses: final report from the early self-management anticoagulation trial II2007 · 94 citations
  3. 3Thrombotic and Bleeding Complications of Prosthetic Heart Valves1987 · 292 citations
  4. 4Management of Anticoagulation in Outpatients1977 · 89 citations
  5. 5Problems Encountered in Long‐term Treatment with Anticoagulants1976 · 54 citations