[Approaches for prescribing anticoagulant therapy to patients with prosthetic heart valves]

The lack of national recommendations and generally accepted strategy of anticoagulant therapy for patients with prosthetic heart valves are principal causes precluding the solution of this problem. The factors responsible for poor efficiency of current therapeutic modalities are heterogeneous response to warfarin, genetic diversity, and frequent thrombosis of prosthetic valves. Neither pharmacogenetic testing for elusive susceptibility to warfarin nor use of portable equipment for detecting threshold coagulation levels can resolve these current problems without improving compliance to medical recommendations and awareness of anticoagulant therapy by both doctors and patients.