z-logo
Premium
Determinants of low‐quality warfarin anticoagulation in patients with mechanical prosthetic heart valves. The nationwide PLECTRUM study
Author(s) -
Pastori Daniele,
Lip Gregory Y. H.,
Poli Daniela,
Antonucci Emilia,
Rubino Luca,
Menichelli Danilo,
Saliola Mirella,
Violi Francesco,
Palareti Gualtiero,
Pignatelli Pasquale
Publication year - 2020
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.16528
Subject(s) - medicine , warfarin , logistic regression , cardiology , odds ratio , diabetes mellitus , heart failure , mechanical heart , surgery , atrial fibrillation , endocrinology
Summary Quality of warfarin therapy in patients with a mechanical prosthetic heart valve (MPHV) has been barely investigated. We analysed determinants of low time in the therapeutic range (TiTR <60%) in 2111 patients with MPHVs from the nationwide PLECTRUM study by the Italian Federation of Anticoagulation Clinics. Overall, 48·5% of patients had a TiTR of < 60%. At logistic regression analysis, arterial hypertension (odds ratio [OR] 1·502, P  < 0·001), diabetes (OR 1·732, P  < 0·001), heart failure (OR 1·484, P  = 0·004), mitral site (vs. aortic) (OR 1·399, P  = 0·006), international normalised ratio (INR) ranges of 2·5–3·5 (OR 2·575, P  < 0·001) and 3·0–4·0 (OR 8·215, P  < 0·001) associated with TiTR < 60%. TiTR is substantially suboptimal in MPHV patients, particularly in higher INR ranges.

This content is not available in your region!

Continue researching here.

Having issues? You can contact us here