Why the study?
Does mechanical heart valve replacement increase sensitivity to warfarin compared to other indications for anticoagulation?
Does mechanical heart valve replacement increase sensitivity to warfarin compared to other indications for anticoagulation?
Patients receiving warfarin immediately after mechanical heart valve replacement exhibit heightened sensitivity to the drug, suggesting that reduced initial dosages may be necessary to prevent over-anticoagulation.
Answers are grounded in this paper and cite their sources.
May support reduced initial warfarin doses after mechanical valve replacement; leaves open confirmation in randomized trials.
We performed a retrospective chart review of 60 patients after mechanical heart valve replacement to assess warfarin sensitivity. The overall international normalized ratio (INR) on day 3 of therapy was 4.1+/-3.9 (range 1.1-17.1). In a control group of 100 patients who received anticoagulation for atrial fibrillation, pulmonary embolism, and deep vein thrombosis, the overall mean INR at day 3 was 1.9+/-0.7 (range 1.0-4.9). The difference between groups was statistically significant (p<0.05). We conclude that patients receiving warfarin after mechanical heart valve replacement are more sensitive to the drug than those receiving it for other indications, and reduced dosages may be necessary during the first 3 days after valve replacement.
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Rose et al. (1998) studied this question.
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