COMPARATIVE ASSESSMENT OF WARFARIN ANTICOAGULATION MANAGEMENT WITH 75 mg VERSUS 150 mg ASPIRIN POST MECHANICAL VALVE REPLACEMENT
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Keywords
Warfarin, Aspirin, Mechanical valve, INR, TTR
Abstract
Background: Attaining stable anticoagulation following mechanical valve replacement presents challenges due to fluctuations in warfarin response. Aspirin is frequently incorporated to improve antithrombotic efficacy; however, the effect of dosage on INR stability and warfarin requirements is not well understood.
Objectives: To evaluate the time in therapeutic range (TTR) and warfarin dosage among patients administered warfarin in conjunction with either 75 mg or 150 mg of aspirin following valve replacement.
Methods: This prospective observational study involved the follow-up of 60 patients over a six-month period post-mechanical valve replacement. Group A was administered warfarin in conjunction with 75 mg of aspirin, while Group B received 150 mg of aspirin. Monthly doses of INR and warfarin were documented, and the time in therapeutic range (TTR) was computed utilizing the Rosendaal method. Data were analyzed utilizing the t-test and chi-square test, with a significance level set at p < 0.05.
Results: The mean INR was comparable between the two groups (2.82 vs. 2.77; p = 0.58). Group B necessitated a mean warfarin dose of 3.35 ± 0.74 mg/day, which was lower than that of Group A at 4.69 ± 0.79 mg/day (p = 0.001). TTR in Group B was significantly higher (73.39 ± 7.00%) compared to Group A (64.15 ± 7.88%; p = 0.001).
Conclusion: The combination of warfarin with 150 mg of aspirin resulted in improved time in therapeutic range (TTR) and reduced warfarin requirements when compared to the use of 75 mg of aspirin, suggesting enhanced anticoagulation stability.
References
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Panmeshwar Rathia
Senior Resident, Department of Cardiac Surgery, PGIMS Rohtak,
Sandeep Singh
Department of Cardiac Surgery, PGIMS Rohtak,
Shoranki Pardhan
Senior Resident, Department of Cardiac Surgery, PGIMS Rohtak,
Cheena Singh
Senior Resident, Department of Cardiac Surgery, PGIMS Rohtak, cheenasingh138@gmail.com
Shamsher Singh Lohchab
Senior Professor and Head, Department of Cardiac Surgery, PGIMS Rohtak,