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Adequate intensity of warfarin therapy for Korean patients with mechanical cardiac valves.

DC Field Value Language
dc.contributor.author이진구-
dc.contributor.author장병철-
dc.date.accessioned2014-12-18T09:58:58Z-
dc.date.available2014-12-18T09:58:58Z-
dc.date.issued2013-
dc.identifier.issn0966-8519-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/89196-
dc.description.abstractBACKGROUND AND AIM OF THE STUDY: The study aim was to identify adequate therapeutic ranges of the International Normalized Ratio (INR) in Korean patients receiving warfarin after prosthetic mechanical heart valve replacement. METHODS: Retrospective chart reviews were conducted of 818 patients for a total follow up period of 8,100 patient-years; all details of major complication events of thromboembolism and bleeding were recorded. The INR-incidence of complication curve was plotted, and an adequate INR determined from the intersections of 95% confidence interval (CI) curves of complication rates to ensure the lowest incidences of both thromboembolic and bleeding complications. An analysis of a subgroup of patients with atrial fibrillation (AF) was performed to evaluate the complication occurrence. RESULTS: A total of 69 complications occurred, of which 36 were thromboembolic events and 33 were bleeding. The adequate ranges of INR were determined as: 2.0-2.5 for patients with aortic or mitral valve replacement; 2.1-2.6 for those with aortic plus mitral valve replacement; and 2.3-2.8 for those with tricuspid valve replacement with or without other valves. It has been shown that, by keeping the INR levels within these therapeutic ranges, complication risks could be significantly reduced by up to 51%. The overall incidence of complications was increased if the patients had AF (hazards risk (HR) = 1.27, 95% CI = 1.05-1.52). CONCLUSION: The study results may provide evidence for the application of low-intensity warfarin therapies in Asian patients, including Koreans. In addition, the method of determining adequate INR levels by using INR-incidence of complications curves might be employed in many clinical settings.-
dc.description.statementOfResponsibilityopen-
dc.relation.isPartOfJOURNAL OF HEART VALVE DISEASE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdult-
dc.subject.MESHAnticoagulants/administration & dosage*-
dc.subject.MESHFemale-
dc.subject.MESHHeart Valve Prosthesis/adverse effects*-
dc.subject.MESHHeart Valve Prosthesis Implantation-
dc.subject.MESHHumans-
dc.subject.MESHInternational Normalized Ratio-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHPostoperative Care-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHThromboembolism/etiology-
dc.subject.MESHThromboembolism/prevention & control*-
dc.subject.MESHWarfarin/administration & dosage*-
dc.titleAdequate intensity of warfarin therapy for Korean patients with mechanical cardiac valves.-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Thoracic & Cardiovascular Surgery (흉부외과학)-
dc.contributor.googleauthorIn Kyung Yoon-
dc.contributor.googleauthorKyung Eun Lee-
dc.contributor.googleauthorJin Koo Lee-
dc.contributor.googleauthorByung Chul Chang-
dc.contributor.googleauthorHye Sun Gwak-
dc.identifier.doi23610997-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA03225-
dc.contributor.localIdA03430-
dc.relation.journalcodeJ01437-
dc.identifier.eissn2053-2644-
dc.identifier.pmid23610997-
dc.subject.keywordAdult-
dc.subject.keywordAnticoagulants/administration & dosage*-
dc.subject.keywordFemale-
dc.subject.keywordHeart Valve Prosthesis/adverse effects*-
dc.subject.keywordHeart Valve Prosthesis Implantation-
dc.subject.keywordHumans-
dc.subject.keywordInternational Normalized Ratio-
dc.subject.keywordMale-
dc.subject.keywordMiddle Aged-
dc.subject.keywordPostoperative Care-
dc.subject.keywordRetrospective Studies-
dc.subject.keywordThromboembolism/etiology-
dc.subject.keywordThromboembolism/prevention & control*-
dc.subject.keywordWarfarin/administration & dosage*-
dc.contributor.alternativeNameLee, Jin Gu-
dc.contributor.alternativeNameChang, Byung Chul-
dc.contributor.affiliatedAuthorLee, Jin Gu-
dc.contributor.affiliatedAuthorChang, Byung Chul-
dc.rights.accessRightsfree-
dc.citation.volume22-
dc.citation.number1-
dc.citation.startPage102-
dc.citation.endPage109-
dc.identifier.bibliographicCitationJOURNAL OF HEART VALVE DISEASE, Vol.22(1) : 102-109, 2013-
dc.identifier.rimsid34439-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers

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