Clinical study of anticoagulation with warfarin and heparin in patients after mechanical valve replacement

Objective To investigate the effect of different methods of anticoagulation after mechanical valve replacement. Methods Totally 172 cases of mechanical valve replacement performed from October 2005 to June 2008 were divided into two groups and then analyzed retrospectively. Patients on warfarin and heparin were classified as the heparin group while those on warfarin alone were classified as the warfarin group. The operation, anticoagulation, anticoagulation index and associated complications were recorded to compare the effect of anticoagulation between two groups. Results warfarin group: the overall anticoagulation effect was satisfactory except for cerebral embolism (n= 1, 1.1%) and lower gastrointestinal hemorrhage (n= 1, 1.1%) during hospitalization. Heparin group: no anticoagulation-related complication was found. The time to reach stable warfarin anticoagulation was shorter than the warfarin group and difference was of significance (8 d ± 3 d vs 11 d ± 4 d,P ＜ 0.01). Ater adjustment of potential confounding factors such as age, gender, weight by linear regression analysis, the result showed that, the time to reach stable warfarin anticoagulation was shortened than the warfarin group by 2.11 days. Statistical significance of difference was observed between two groups (P ＜ 0.01). Conclusion It is both safe and effective to anticoagulate the patients after mechanical valve replacement with warfarin and heparin. Key words: Warfarin; Heparin; Anticoagulation; Mechanical valve replacement