ArticleThrombosis and haemostasis2024
Outcomes of Patients with a Mechanical Heart Valve and Poor Anticoagulation Control on Warfarin.
Article in Thrombosis and haemostasis, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 18 citations in OpenAlex.
- Trial
- Mechanical Aortic Valve Replacement Following Self-Inflicted Cardiac Needle Penetration in a Patient with Recurrent Self-Harm: A Case Report with Fatal Long-Term Outcome.Journal of clinical medicine · 2026Article
- Causal Effects of Atrial Fibrillation and Warfarin Use on Osteoporosis Risk: A Two-Sample Mendelian Randomization Analysis.International journal of genomics · 2026Article
- Oxidative Stress Related to Mechanical Heart Valves: A Pilot Cross-Sectional Study.Antioxidants (Basel, Switzerland) · 2025Article
- A predictive model for differentiating causes of elevated mechanical prosthetic aortic valve gradient.The international journal of cardiovascular imaging · 2025Article
- Review
- Association between gene polymorphisms and initial warfarin therapy in patients after heart valve surgery.Pharmacological reports : PR · 2024Article
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Authors and funding
16 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with a mechanical heart valve (MHV) require oral anticoagulation. Poor anticoagulation control is thought to be associated with adverse outcomes, but data are limited.
objectiveTo assess the risks of clinical outcomes in patients with a MHV and poor anticoagulation control on warfarin.
methodsWe conducted a retrospective study of consecutive patients undergoing MHV implantation at a tertiary care center (2010-2019). Primary outcome was a composite of ischemic stroke, systemic embolism, or prosthetic valve thrombosis. Major bleeding and death were key secondary outcomes. We constructed multivariable regression models to assess the association between time in therapeutic range (TTR) on warfarin beyond 90 days after surgery with outcomes.
resultsWe included 671 patients with a MHV (80.6% in aortic, 14.6% in mitral position; mean age 61 years, 30.3% female). Median follow-up was 4.9 years, mean TTR was 62.5% (14.5% TTR <40%, 24.6% TTR 40-60%, and 61.0% TTR >60%). Overall rates of the primary outcome, major bleeding, and death were 0.73, 1.41, and 1.44 per 100 patient-years. Corresponding rates for patients with TTR <40% were 1.31, 2.77, and 3.22 per 100 patient-years. In adjusted analyses, every 10% decrement in TTR was associated with a 31% increase in hazard for the primary outcome (hazard ratio [HR]: 1.31, 95% confidence interval [CI]: 1.13-1.52), 34% increase in major bleeding (HR: 1.34, 95% CI: 1.17-1.52), and 32% increase in death (HR: 1.32, 95% CI: 1.11-1.57).
conclusionIn contemporary patients with a MHV, poor anticoagulation control on warfarin was associated with increased risks of thrombotic events, bleeding, and death.
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