Key result
Warfarin dose requirements significantly increased during the first 12 weeks for patients with aortic and mitral valve replacements (p<0.001), a trend not observed in atrial fibrillation patients.
Why the study?
Does the indication for warfarin (heart valve replacement vs atrial fibrillation) affect the dose requirement during the first 12 weeks of therapy?
Observational (n=133)
No
Does the indication for warfarin (heart valve replacement vs atrial fibrillation) affect the dose requirement during the first 12 weeks of therapy?
Mean Difference: 0.613 (95% CI 0.045–1.182)
p-value: p=0.030
Patients undergoing heart valve replacement require progressive warfarin dose increases and more frequent monitoring during the first 3 months of therapy compared to patients with atrial fibrillation.
Warfarin dosing varies post-valve surgery in AF; hypothesis-generating and should not yet change practice.
This study was conducted to evaluate the changes in warfarin doses among patients after heart valve surgery and atrial fibrillation. A total of 137 patients having AF, AVR and MVR whom initiate warfarin therapy in year 2008 till 2010 in Penang Hospital were selected as samples for this study. Data collected included patient's age, race, gender, warfarin initiation date, warfarin indication, warfarin dose and INR value for 1 st till 12 th weeks of warfarin initiation. Heart valve replacement patients (AVR or MVR) showed increasing trend in warfarin doses during the initial phase of warfarin therapy. This trend was not observed in AF patients. The dose of warfarin was significantly different within first 12 weeks of warfarin initiation for AVR and MVR group (p<0.001) but there was no significant difference in AF group. The dose of warfarin was significantly different among AVR and AF patients for first 5 weeks of warfarin initiation. Monitoring should be frequent for patients with heart valve replacement during the initial 3 months period of warfarin therapy.
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Aziz et al. (2016) conducted an observational in Atrial fibrillation, aortic valve replacement, mitral valve replacement (n=133). Warfarin therapy vs. Comparison between indications (AF, AVR, MVR) was evaluated on Mean difference in warfarin dose between atrial fibrillation and aortic valve replacement groups (MD 0.613 mg, 95% CI 0.045-1.182, p=0.030). Warfarin dose requirements significantly increased during the first 12 weeks for patients with aortic and mitral valve replacements (p<0.001), a trend not observed in atrial fibrillation patients.
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