Frequency of prothrombin time-international normalized ratio monitoring and the long-term prognosis in patients with mechanical valve replacement

BMC Cardiovascular Disorders

Research

Minglong Chen¹  Mingfang Li¹  Yongfeng Shao²  Hong Liu²  Weidong Gu²  Jiaxi Gu²  Buqing Ni²  Le Geng²  Minghui Li²  Haoliang Sun² 

[1] Division of Cardiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, P.R. China;Division of Cardiovascular Surgery, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, P.R. China;

关键词: Mechanical heart valve;    Warfarin;    Prothrombin time-international normalized ratio;    Monitoring frequency;   

DOI  :  10.1186/s12872-023-03293-w

 received in 2022-12-11, accepted in 2023-05-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe study aimed to assess the correlation between the monitoring frequency of PT-INR and the long-term prognosis in patients with mechanical heart valve (MHV) replacement after discharge.MethodsThis single-center, observational study enrolled patients who underwent MHV replacement and discharged from June 2015 to May 2018. Patients or their corresponding family members were followed with a telephone questionnaire survey in July-October 2020. Based on monitoring intervals, patients were divided into frequent monitoring (FM) group (≤ 1 month) and less frequent monitoring (LFM) group (> 1 month). The primary endpoint was the composite of thromboembolic event, major bleeding or all-cause death. The secondary endpoints were thromboembolic event, major bleeding or all-cause death, respectively.ResultsA total of 188 patients were included in the final analysis. The median follow-up duration was 3.6 years (Interquartile range: 2.6 to 4.4 years). 104 (55.3%) patients and 84 (44.7%) patients were classified into the FM group and the LFM group, respectively. The FM group had a significantly lower incidence of the primary endpoint than the LFM group (3.74 vs. 1.16 per 100 patient-years, adjusted HR: 3.31 [95% CI 1.05–10.42, P = 0.041]). Secondary analysis revealed that the risk of thromboembolic events and all-cause death were also reduced in the FM group.ConclusionsThe management of warfarin treatment in patients after MHV replacement remains challenging. Patients with less frequent monitoring of PT-INR might have worse clinical prognosis than those with frequent PT-INR monitoring.

【 授权许可】

CC BY   
© The Author(s) 2023

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