Why the study?
Does the hypercoagulability marker F1+2 indicate inadequate suppression of hypercoagulability in patients with heart valve prostheses on warfarin with therapeutic INR?
Does the hypercoagulability marker F1+2 indicate inadequate suppression of hypercoagulability in patients with heart valve prostheses on warfarin with therapeutic INR?
Determination of F1+2 levels may help identify patients with heart valve prostheses on warfarin who remain hypercoagulable despite having a therapeutic INR.
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F1+2 elevation may flag persistent hypercoagulability in valve prosthesis patients on warfarin despite therapeutic INR; hypothesis-generating and requires prospective validation.
OBJECTIVE: To investigate whether patients with heart valve prostheses and similar International Normalized Ratios (INR) have the same level of protection against thromboembolic events, that is, whether the anticoagulation intensity is related to the intensity of hypercoagulability suppression. METHODS: INR and plasma levels of prothrombin fragment 1+2 (F1+2) were assessed in blood samples of 27 patients (7 with mechanical heart valves and 20 with biological heart valves) and 27 blood samples from healthy donors that were not taking any medication. RESULTS: Increased levels of F1+2 were observed in blood samples of 5 patients with heart valve prostheses taking warfarin. These findings reinforce the idea that even though patients may have INRs, within the therapeutic spectrum, they are not free from new thromboembolic events. CONCLUSION: Determination of the hypercoagulability marker F1+2 might result in greater efficacy and safety for the use of oral anticoagulants, resulting in improved quality of life for patients.
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Ferreira et al. (2002) studied this question.
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