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[A systemic review of low intensity anticoagulation therapy for Chinese population with heart valve replacement]
Li Dong1, Yingkang Shi2, Bo Fu
1Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Insights
Low intensity anticoagulation therapy (INR ≤ 2.5) significantly reduces bleeding and complications in Chinese patients after heart valve replacement without increasing clot risk. This approach is safe and effective for this population.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Heart valve replacement necessitates anticoagulation therapy.
- Optimizing anticoagulation intensity is crucial for balancing efficacy and safety.
- Chinese populations may have unique coagulation characteristics influencing therapy response.
Purpose of the Study:
- To evaluate the safety and efficacy of low-intensity anticoagulation therapy.
- To assess outcomes in Chinese patients undergoing heart valve replacement.
Main Methods:
- Systematic literature search of multiple databases (CBM, CNKI, VIP, PubMed, Cochrane Library) from January 1999 to October 2010.
- Inclusion and exclusion criteria for study selection and quality assessment.
- Meta-analysis of control studies and descriptive analysis of observational studies.
Main Results:
- Review of 61 articles (4 control, 57 descriptive studies).
- Low-intensity anticoagulation significantly decreased anticoagulation-related complications and bleeding events compared to classical intensity (P < 0.001).
- No significant difference in thromboembolic event risk between low-intensity and classical-intensity groups (P > 0.05).
Conclusions:
- Low-intensity anticoagulation therapy (INR ≤ 2.5) effectively minimizes hemorrhage and mortality.
- This therapy does not increase the risk of thromboembolic events.
- It is a safe, effective, and suitable option for the Chinese population's coagulation profile.
Objective:
To investigate the safety and efficacy of low intensity anticogulation therapy for chinese population underwent heart valve replacemnt.
Methods:
From January 1999 to October 2010, the literatures concering anticoagulation therapy for chinese population with heart valve replacement were researched in following databases: CBM, CNKI, VIP, Pubmed as well as cochrane library. Screening and quality evaluation was conducted according to the inclusion and exclusion criteria. Meta-analysis of control studies and descriptive analysis of descriptive studies were conducted.
Results:
Total 61 articles were reviewed, including 4 control studies and 57 descriptive studies. Both Meta analysis and descriptive analysis results showed also that the rates of total anticoagulation-related complications as well as bleeding events were significantly decreased in patients receiving low intensity anticoagulation therapy in compared with classical intensity strategy (RR = -0.06, 95%CI: -0.08--0.03, P < 0.001;RR = -0.06 , 95%CI:-0.08-0.04, P < 0.001), while no significant differeces were noted as for risk of thrmoboembolic events among two different intensity groups (RR = 0.01, 95%CI:-0.01-0.03, P > 0.05).
Conclusions:
Low intensity anticoagulation therapy (INR ≤ 2.5) could effectively miminze the anticoagulation-related hemorrhage and mortality rates and while without increasing the rates of thrmoboembolic event. This therapy was safe, effective and suitable for the coagulation characteristics of Chinese population.
