Analysis of factors for international normalized ratio levels>3.0 in patients undergoing warfarin anticoagulation therapy after mechanical heart valve replacement_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHAO Shengmin ^1,2 , FU Bo ³ , ZHANG Fengying ⁴ , MA Weijie ² , HUANG Shourui ⁵ , LI Qian ⁶ , TAO Huan ⁷ , DONG Li ¹ ,  CHEN Jin ^1,2

1. Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
2. Clinical Epidemiology and Evidence-based Medicine Research Center, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
3. Department of Cardiovascular Surgery, Tianjin Chest Hospital, Tianjin, 300222, P. R. China;
4. Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region, Chengdu, 610041, P. R. China;
5. West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, P. R. China;
6. Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
7. Department of Hematology and Research Laboratory of Hematology, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;

Corresponding author：

CHEN Jin, Email: ebm_chenjin@126.com

Keywords：

Mechanical heart valve replacement; warfarin; anticoagulation therapy; international normalized ratio

DOI：

10.7507/1007-4848.202402023

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Objective To investigate the factors influencing international normalized ratio (INR)>3.0 in patients undergoing warfarin anticoagulation therapy after mechanical heart valve replacement. Methods A retrospective analysis was performed on the clinical data of patients who underwent mechanical heart valve replacement surgery and received warfarin anticoagulation therapy at West China Hospital of Sichuan University from January 1, 2011 to June 30, 2022. Based on the discharge INR values, patients were divided into two groups: an INR≤3.0 group and an INR>3.0 group. The factors associated with INR>3.0 at the time of discharge were analyzed. Results A total of 8901 patients were enrolled, including 3409 males and 5492 females, with a median age of 49.3 (43.5, 55.6) years. The gender, body mass index (BMI), New York Heart Association (NYHA) cardiac function grading, INR, glutamic oxaloacetic transaminase, and preoperative prothrombin time (PT) were statistically different between the two groups (P<0.05). Multivariate logistic regression analysis revealed that lower BMI, preoperative PT>15 s, and mitral valve replacement were independent risk factors for INR>3.0 at discharge (P<0.05). Conclusion BMI, preoperative PT, and surgical site are factors influencing INR>3.0 at discharge in patients undergoing warfarin anticoagulation therapy after mechanical heart valve replacement. Special attention should be given to patients with lower BMI, longer preoperative PT, and mitral valve replacement to avoid excessive anticoagulation therapy.

Citation： ZHAO Shengmin, FU Bo, ZHANG Fengying, MA Weijie, HUANG Shourui, LI Qian, TAO Huan, DONG Li, CHEN Jin. Analysis of factors for international normalized ratio levels>3.0 in patients undergoing warfarin anticoagulation therapy after mechanical heart valve replacement. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2025, 32(5): 655-662. doi: 10.7507/1007-4848.202402023 Copy

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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Analysis of factors for international normalized ratio levels>3.0 in patients undergoing warfarin anticoagulation therapy after mechanical heart valve replacement

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