Optimal oral anticoagulant therapy in patients with mechanical heart valves

Article Abstract:

The best dosage of anticlotting drugs for patients with artificial heart valves may be one that produces an international normalized ratio (INR) of coagulation between 2.5 and 4.9. Researchers analyzed the medical records of 1608 patients with artificial heart valves. The patients received coumarin derivative anticlotting drugs. The total follow-up time was 6475 patient-years, at an average of 4 years per patient. For patients with a INR between 2.5 and 4.9 the rate of blood vessel blockage or bleeding was about 2 per 100 patient-years. At INR levels below 2.5 the incidence of clotting increased sharply. At INR levels above 4.9 the incidence of hemorrhages increased sharply. An INR between 3.0 and 4.0 may be the best target in administering the drugs.

Prognosis, Heart valve prosthesis, Artificial heart valves

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Care of patients receiving long-term anticoagulant therapy

Article Abstract:

Patients with artificial heart valves, mitral valve disease, atrial fibrillation, and venous thromboembolism should be treated with long-term anticoagulants to prevent abnormal blood clotting. They should be given a dose to produce an international normalized ratio (INR) of 2 to 3. A monthly prothrombin time test can be used to adjust the dose and vitamin K can be given if necessary to reduce the risk of excessive bleeding.

Prevention, Thrombosis, Blood clot, Hypercoagulation

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D-dimer testing to determine the duration of anticoagulation therapy

Article Abstract:

D-dimer levels are tested to assess the optimal duration of oral anticoagulation in patients with idiopathic venous thromboembolism. It is evaluated that patients with abnormal D-dimer have a recurrence of venous thromboembolism after the discontinuation of anticoagulation but reduces on its resumption whereas for patients with normal D-dimer level, the optimal course of anticoagulation is not clearly established.

Drug therapy, Thrombophlebitis, Clinical report

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