ArticleBritish journal of clinical pharmacology2025
Anticoagulation intensity and outcomes among southeast-Asians with moderate-to-severe mitral valve stenosis.
Article in British journal of clinical pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Anticoagulation intensity and outcomes among southeast-Asians with moderate-to-severe mitral valve stenosis.British journal of clinical pharmacology · 2025Article
- Smart Thrombosis Care: The Rise of Closed-Loop Diagnosis-to-Treatment Nano Systems.International journal of nanomedicine · 2025Review
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Authors and funding
7 authors.
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Abstract
objectiveTo determine the optimal anticoagulation intensity of warfarin in a South-East Asian population with moderate-to-severe rheumatic mitral stenosis.
methodsA multicentre, retrospective study examined patients with rheumatic mitral stenosis who had not undergone valve replacement or repair and required long-term warfarin therapy at two hospitals in Thailand from 2013 to 2018. The main outcomes were thromboembolism and major bleeding. Incidence rate ratios for these events at each level of anticoagulation intensity (international normalized ratio [INR]) were compared.
resultsThe study included 933 patients with 3538 patient-years of follow-up, a mean follow-up of 3.8 years and 23 700 INR values. Mean age was 56.1 ± 11.8 years. During follow-up, there were 149 thromboembolic events (4.2 per 100 patient-years) and 132 major bleeding events (3.7 per 100 patient-years). Net adverse clinical events were lowest at INR 2.50-2.99, with no significant difference between INR 2.00-2.49 and 3.00-3.50. Standard INR (2.0-3.0) and high-intensity INR (2.5-3.5) had comparable net adverse clinical event rates (incidence rate ratio 0.99, 95% confidence interval [CI] 0.66-1.54, P = .99). However, thromboembolism incidence was higher with standard INR (incidence rate ratio 2.49, 95% CI 1.13-6.23, P = .013), while major bleeding was lower (incidence rate ratio 0.57, 95% CI 0.35-0.98, P = .045). No significant difference in intracranial haemorrhage rates was observed between the two INR intensities.
conclusionThe standard anticoagulation intensity is an optimal range for Asian population with moderate-to-severe rheumatic mitral stenosis. High intensity anticoagulation (INR of 2.50-3.50) further reduces thromboembolism but increases major bleeding but not intracranial haemorrhage.
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