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Anticoagulation After Coronary Artery Surgery in Patients With Polycythemia Vera: Report of Two Cases
Author(s) -
Oz Bilgehan Savaş,
Asgun Fatih,
Akay Hakki Tankut,
Kaya Erkan,
Kuralay Erkan,
Tatar Harun
Publication year - 2007
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2007.00438.x
Subject(s) - medicine , aspirin , clopidogrel , polycythemia vera , warfarin , cardiology , phlebotomy , antiplatelet drug , thrombosis , anticoagulant , artery , coronary artery bypass surgery , coronary artery disease , surgery , atrial fibrillation
Polycythemia vera is a myeloproliferative disorder associated with the thromboembolic events. Normalization of the hematocrit and elevated platelet counts is obligatory to reduce the thrombotic risk of patients with PV. Therapeutic strategies include phlebotomy, myelosuppressive agents, and, more recently, interferon‐α. In addition, appropriate antiplatelet therapy should be administered to prevent life‐threatening complications and reducing the viscosity of the blood. Although aspirin is widely preferred in such patients, this monodrug therapy or combined with clopidogrel as an alternative approach might not be enough, especially after coronary artery surgery. Therefore, warfarin should be added to anticoagulant therapy. This short report describes the use of warfarin, associated with aspirin and clopidogrel as an anticoagulant regimen after coronary artery bypass surgery in two cases with polycythemia vera. We believe that a combination of warfarin with other oral antiplatelet agents may be more effective in preventing the coronary artery bypass graft thrombosis.