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.

Determinants of low-quality warfarin anticoagulation in patients with mechanical prosthetic heart valves. the nationwide PLECTRUM study / Pastori, D.; Lip, G. Y. H.; Poli, D.; Antonucci, E.; Rubino, L.; Menichelli, D.; Saliola, M.; Violi, F.; Palareti, G.; Pignatelli, P.. - In: BRITISH JOURNAL OF HAEMATOLOGY. - ISSN 0007-1048. - 190:4(2020), pp. 588-593. [10.1111/bjh.16528]

Determinants of low-quality warfarin anticoagulation in patients with mechanical prosthetic heart valves. the nationwide PLECTRUM study

Pastori D.
Primo
;
Rubino L.;Menichelli D.;Saliola M.;Violi F.;Pignatelli P.
Ultimo
2020

Abstract

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.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11573/1383622
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