Low standard oral anticoagulation therapy for Chinese patients with St. Jude mechanical heart valves / 中华医学杂志(英文版)
Chinese Medical Journal
;
(24): 1175-1178, 2003.
Article
in English
| WPRIM
| ID: wpr-294139
ABSTRACT
<p><b>OBJECTIVE</b>To study the efficacy of the low standard oral anticoagulation therapy following St Jude Medical (SJM) valve implantation for Chinese patients.</p><p><b>METHODS</b>Totally 805 patients with a mean age of 42.70 +/- 11.09 years, enrolled into this study. Among them, 230 underwent aortic valve replacements (AVR), 381 mitral valve replacements (MVR), 189 double valve replacements (DVR) and 5 tricuspid valve replacements (TVR). All patients received postoperative oral anticoagulation therapy based on a low standard of international normalized ratio (INR, 2.0 - 2.5). Of the 805 patients, 710 were followed up for 0.25 - 13 years (a median, 4.15 years).</p><p><b>RESULTS</b>Postoperatively, 17 adverse events occurred. Operative mortality was 2.11%. The most frequent cause of operative mortality was a low cardiac output. During follow-up, there were 47 anticoagulant-induced hemorrhages [1.59%/patient-year (pt-yr)], 10 cases of thromboembolism (0.34%/pt-yr), and 3 mechanical valve thromboses (0.19%/pt-yr). There were 44 late deaths and the linearized late mortality rates were 0.51%pt-yr. Estimates of actuarial survival for all patients at 5 and 10 years was 97.45% (0.70%) and 77.96% (17.44%), respectively.</p><p><b>CONCLUSIONS</b>A low target INR range of 2.0 - 2.5 is preferable for Chinese patients so as to reduce the severe bleeding complications in those with conventionally higher levels of INR. The long-term results were satisfactory in terms of the numbers of those who suffered thrombosis, embolism and bleeding.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Postoperative Complications
/
Heart Valve Prosthesis
/
China
/
Administration, Oral
/
Follow-Up Studies
/
Asian People
/
Anticoagulants
Type of study:
Observational study
/
Prognostic study
Limits:
Adolescent
/
Adult
/
Aged
/
Child
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
English
Journal:
Chinese Medical Journal
Year:
2003
Type:
Article
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