Zou Kun, Wei Dachuang, Xiang Bo, Yu Tao, Huang Keli, Liu Shengzhong
NHC Key Laboratory of Nuclear Technology Medical Transformation(MIANYANG CENTRAL HOSPITAL), Mianyang, Sichuan Province, 621000, China.
Cardiac Surgery Center, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology, Chengdu, Sichuan Province, 610072, China.
J Cardiothorac Surg. 2025 Jan 9;20(1):49. doi: 10.1186/s13019-024-03215-7.
To explore the safety and efficacy of low-intensity anticoagulation in patients after On-X mechanical aortic valve replacement.
A total of 104 patients undergoing aortic valve replacement in Cardiac Surgery Department of Sichuan Provincial People's Hospital from December 2018 to December 2021 were randomly divided into low-intensity anticoagulant (INR:1.5-2.0) and high-intensity anticoagulant (INR:2.0-2.5) to compare the incidence of adverse events related to postoperative anticoagulation between the two groups.
Fifty-three patients were included in the low-intensity anticoagulation group (INR 1.5-2.0), and 51 patients were included in the high-intensity group (2.0-2.5). There was no significant difference in baseline data and surgical index between the two groups (P > 0.05); there were statistically significant differences in PT, INR and bleeding events (P < 0.05), but no significant difference in embolic events (P > 0.05).
For patients requiring On-X mechanical aortic valve replacement who have no risk factors for thromboembolism, it is appropriate to control the INR in the target range 1.5-2.0, which can reduce the incidence of bleeding adverse events and significantly improve the quality of life, without increasing the risk of thromboembolic adverse events.
探讨On-X机械主动脉瓣置换术后患者低强度抗凝的安全性和有效性。
选取2018年12月至2021年12月在四川省人民医院心脏外科行主动脉瓣置换术的104例患者，随机分为低强度抗凝组（国际标准化比值[INR]：1.5 - 2.0）和高强度抗凝组（INR：2.0 - 2.5），比较两组术后抗凝相关不良事件的发生率。
低强度抗凝组纳入53例患者（INR 1.5 - 2.0），高强度组纳入51例患者（2.0 - 2.5）。两组基线数据和手术指标无显著差异（P＞0.05）；凝血酶原时间（PT）、INR和出血事件有统计学显著差异（P＜0.05），但栓塞事件无显著差异（P＞0.05）。
对于行On-X机械主动脉瓣置换且无血栓栓塞危险因素的患者，将INR控制在1.5 - 2.0的目标范围内是合适的，可降低出血不良事件的发生率，显著提高生活质量，且不增加血栓栓塞不良事件的风险。
