Variations of the International Standard Ratio in complicated patients with valve prosthesis
Keywords:
International Standard Ratio, valve prosthesis, oral anticoagulation, secondary health care.Abstract
An observational, descriptive and cross-sectional study of 51 patients with valve prosthesis was carried out. They were admitted to theCardiologyCenterof “Saturnino Lora Torres”TeachingClinicalSurgicalProvincialHospitaldue to valve thrombosis or bleeding episodes, from January, 2012 to December, 2014, with the purpose of estimating the variations in the International Standard Ratio values and their association with these events. The chi-square test was carried out. Those patients affected with valve thrombosis (60.4%) and International Standard Ratio under 2.5 were predominant; while the latter in bleedings was over 3.5. The patients with more than one associated risk factor presented higher quantity of thrombosis episodes; events that had less incidence when warfarin and aspirin were included in the treatment.
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References
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2. Ordúñez García PO, Cooper RS, Espinosa Brito AD, Iraola Ferrer MD, Bernal Muñoz JL, La Rosa Linares Y. Enfermedades cardiovasculares en Cuba: determinantes para una epidemia y desafíos para la prevención y control. Rev Cubana Salud Pública. 2005 [citado 2 Sept 2015]; 31(4). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-34662005000400002
3. Rahimtoola SH. Choice of prosthetic heart valve for adult patients. J Am Coll Cardiol. 2013 [citado 20 Abr 2015]; 41(6). Disponible en: http://www.sciencedirect.com/science/article/pii/S0735109702029650
4. Koertke H, Zittermann A, Wagner O, Koerfer R. Self-management of oral anticoagulation therapy improves long-term survival in patients with mechanical heart valve replacement. Ann Thorac Surg. 2007; 83(1):24-9.
5. Teixeira Rocha H, Rejane Rabelo E, Aliti G, Nogueira de Souza E. Conocimiento de los pacientes portadores de prótesis valvular mecánica sobre la terapia de anticoagulación oral crónica. Rev Latino-Am Enfermagem. 2010 [citado 2 Sep 2015]; 18(4). Disponible en: http://www.scielo.br/pdf/rlae/v18n4/es_06.pdf
6. Zucker S, Cathey MH, Sox PJ, Hall EC. Standardization of laboratory tests for controlling anticoagulent therapy. Am J Clin Pathol. 1970; 53(3):348-54.
7. Suardíaz J, Cruz C, Colina A. Laboratorio clínico. La Habana: Editorial Ciencias Médicas; 2004. p. 328.
8. Meschengieser SS, Casais P, Sanchez Luceros A, Lazzari MA. Presente y futuro de los anticoagulantes orales. Medicina (Buenos Aires). 2000; 60:139-42.
9. Araguás C, Aranalde JM, Asensio A, Bosch MA, Bustins A, Caballero G, et al. Protocolos para el control del tratamiento anticoagulante oral. 2012 [citado 18 Ene 2015]. Disponible en: http://www.agefec.org/Almacen/protocolos%20y%20programas/PROTOCOLO%20TAO%20cataluna.pdf
10. Yiu KH, Siu CW, Jim MH, Tse HF, Fan K, Chau MC, Chow WH. Comparison of the efficacy and safety profiles of intravenous vitamin K and fresh frozen plasma as treatment of warfarin-related over-anticoagulation in patients with mechanical heart valves. Am J Cardiol. 2006; 97(3):409-11.
11. Vasquez JC, Barrantes CA, Peralta JE, Rojas LE. Tratamiento quirúrgico de la enfermedad valvular cardiaca de predominio izquierdo, en un hospital de referencia nacional de Lima, Perú. Rev Perú Med Exp Salud Pública. 2013 [citado 4 Jul 2015]; 30(3). Disponible en: http://www.scielo.org.pe/scielo.php?pid=S1726-46342013000300007&script=sci_arttext
12. De la Cruz Avilés LE, Coll Muñoz Y, García Cuesta D. Comportamiento clínico y evolutivo de la disfunción valvular protésica. Experiencia de 5 años. Rev Cubana Cardiol Cir Cardiovasc. 2011[citado 15 Jun 2015]; 17(4):311-6.
13. Flores Moya AL. Factores que modifican el índice internacional ajustado en los pacientes con anticoagulación oral. Rev Mex Enfermer Cardiológica. 2009 17(1-3):6-9.
14. Freixa R, Blanch P, Ibernón M, Padró J, Delso J, Sobrepera JL, et al. Identificación de factores responsables de anticoagulación oral excesiva en pacientes ambulatorios con cardiopatía. Rev Esp Cardiol. 2003; 56(1):65-72.
15. Marín A, Neira V, Aizman A, Paredes A, Palma S, Ruiz M, et al. Eficacia y seguridad del tratamiento anticoagulante oral con antagonistas de vitamina K en pacientes con prótesis valvulares cardíacas. Rev Chil Cardiol. 2014 [citado 21 Feb 2015]; 33(1). Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0718-85602014000100003
16. Whitlock RP, Sun JC, Fremes SE, Rubens FD, Teoh KH. Antithrombotic and thrombolytic therapy for valvular disease: Antithrombotic therapy and prevention of thrombosis. 9th ed. American College of Chest Physicians Evidence-based clinicial practice guidelines. Chest. 2012; 141(2 suppl):576S-600S.
17. Arias Núñez MC. Manejo de la anticoagulación en pacientes con válvulas cardíacas mecánicas: hemorragia mayor y procedimientos invasivos. Lugo: Complexo Hospitalario Xeral-Calde. 2007 [citado 12 May 2015]. Disponible en: http://www.meiga.info/evidenciasMI/hemorragia.pdf
18. Eikelboom JW, Wallentin L, Connolly SJ, Ezekowitz M, Healey JS, Oldgren J, et al. Risk of bleeding with 2 doses of dabigatran compared with warfarin in older and younger patients with atrial fibrillation: analysis of the randomized evaluation of long-term anticoagulant therapy (RE-LY) trial. Circulation. 2011; 123(21):2363-72.
19. Tan WA, Moliterno DJ. Aspirin, ticlopidine, and clopidogrel in acute coronary syndromes: underused treatments could save thousands of lives. Cleve Clin J Med. 1999; 66(10):615-28.
20. Steinhubl SR, Topol EJ. Clopidogrel with aspirin is the optimal antiplatelet regimen for intracoronary stenting. J Thromb Thrombolysis. 1999; 7(3):227-31.
Published
2017-04-06
How to Cite
1.
Rodríguez Borges S, Durañones Góngora S, Castillo Martínez JM, Romero Garcìa LI, Gondres Legrò KM. Variations of the International Standard Ratio in complicated patients with valve prosthesis. MEDISAN [Internet]. 2017 Apr. 6 [cited 2025 May 30];21(4). Available from: https://medisan.sld.cu/index.php/san/article/view/954
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