기계판막치환 한국인 환자의 적정 INR분석

Abstract

Anticoagulation therapy must be done to patients with mechanical heart valves for prevention of thromboembolism (TE). But, there are no guidelines for the optimal therapeutic range of anticoagulation therapy in Korean patients. Thus, this study performed to evaluate the optimal therapeutic range in International normalized ratio (INR) value in Korean patients with mechanical heart valves. The charts and ACS records of 252 patients with mechanical heart valves who have been followed up at the department of thoracic cardiovascular surgery of Korea university Anam hospital were reviewed retrospectively from Feb. 2002 to Sep. 2005. The target INR range was between 1.5 and 2.0. Mean duration of follow up was 2.9 years and total duration was 746.67 patient-years. All patients were treated with antiplatelet agents. Complications occurred in 18 patients (10 cases of TE, 8 cases of major bleeding), but only 12 cases(7 of TE, 5 of major bleeding) contributed to analysis of the complication incidence. The incidence of complications per 100 patient-years in each INR 1.0~1.49, 1.50~1.99, 2.0~2.49, 2.5~2.99, ≥3.0 was 2.41, 0.35, 0.80, 2.52, 11.43, respectively. In conclusion, the INR range of the lowest incidence rate of complication was between 1.5 and 2.49 in Korean patients with mechanical vale replacement (p=0.01).