Low Intensity Anticoagulation Therapy for Chinese Population with Heart Valve Replacement——3 000 Cases Follow-up

Objective To investigate the effect of low-intensity anticoagulation therapy for Chinese population with heart valve replacement. Methods From January 2011 to March 2012, 3 000 patients with heart valve replacement in Fuwai Hospital and West China Hospital were followed-up for 1 year, the method and intensity of postoperative anticoagulation, as well as the complications were studied and analyzed. Results The rate of follow-up was 88.57%, and the cumulative follow-up was 1 726.1 patient-years (Pty). The mean oral warfarin dosage was （2.68±6.45） mg/d, and the mean INR values of the patients treated in Fuwai Hospital and West China Hospital were 2.01±1.10 and 1.86±0.69 respectively (total 54 379 samples).The total rates of anticoagulation complication and mortality were 5.79% Pty and 0.12% Pty respectively, among which the morbidity and mortality of hemorrhage were 3.59% Pty and 0.12% Pty respectively, while the morbidity and mortality of thromboembolism were 2.03% Pty and 0.00% Pty respectively. There are no significant differences of actual anticoagulation intensity （P=0.28）and the complication rates between the two hospitals .Conclusion The optimal intensity scope (INR) of 1.5-2.5 (mean 1.8-2.0) is safe and efficient for Chinese patients with prosthetic heart valves, and no significant regional difference in the intensity of anticoagulation therapy required.