Objective To evaluate the effects of the preoperative factors, drug factors and demographic factors on the early warfarin anticoagulation after heart valve replacement.
Methods One hundred and four patients treated with heart valve replacement were retrospectively analyzed.The data related to anticoagulation treatment, which included the basic information(hospital number, gender, age and body mass), general clinical data, concomitant use of amiodarone and initial doses were collected.The correlation between the above indicators and early postoperative stable warfarin dose, first time to reach the international normolized ratio(INR) and time in therapeutic range (TTR) were evaluated.
Results The stable dose of warfarin in female patients and patients over 60 years old were significantly lower than that in male patients and patients aged 40-59 years old(P < 0.05), and the stable dose of warfarin increased with the increasing of body mass(P < 0.05).Compared with warfarin alone, the patients treated with warfarin and amiodarone took longer time to reach the initial target INR(P < 0.01), and the rate of anticoagulation of which reaching the standard was lower(P < 0.05).The TTR in female patients and patients with initial dose of 5 mg were significantly higher than that in male patients and patients with initial dose of 2.5 mg(P < 0.01).
Conclusions The initial dose, drug interactions and demographic factors should be considered when warfarin is used as anticoagulant after heart valve replacement.
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