Related Experiment Video
Updated: Jun 8, 2026
23:33
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
84.0K
New Internet-Based Warfarin Anticoagulation Management Approach After Mechanical Heart Valve Replacement:
Zhihui Zhu1,2, Chenyu Li3, Jinglun Shen1
1Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Journal of Medical Internet Research
|August 16, 2021
Summary
Internet-based warfarin management significantly improves time in therapeutic range and reduces bleeding and embolic events in patients with mechanical heart valves. This approach offers a superior alternative to conventional warfarin management for long-term anticoagulation.
Area of Science:
- Cardiology
- Medical Informatics
Background:
- Mechanical heart valve replacement (MHVR) necessitates lifelong warfarin therapy, posing risks of bleeding and thrombosis.
- The efficacy of internet-based warfarin management in mitigating these complications remains unclear.
Purpose of the Study:
- To compare internet-based warfarin management with conventional methods in MHVR patients.
- To provide evidence for alternative long-term anticoagulation strategies.
Main Methods:
- A prospective, multicenter, randomized, open-label, controlled trial with 1-year follow-up.
- 721 patients undergoing MHVR were randomized into conventional or internet-based management groups.
- Primary outcome: time in therapeutic range (TTR); Secondary outcomes: bleeding and thrombosis events.
Main Results:
- The internet-based group demonstrated significantly higher TTR (0.53 vs. 0.46, P<.001).
- Anticoagulation complications (bleeding, embolic events) were less frequent in the internet-based group (6.94% vs. 12.74%, P=.01).
- Internet-based management increased TTR by 7% and reduced complication risk by 6% (P<.001).
Conclusions:
- Internet-based warfarin management is superior to conventional methods for MHVR patients.
- This approach effectively reduces anticoagulation-related complications.
Related Concept Videos
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
01:18Endocarditis III: Medical Management
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
01:21Rheumatic Heart Disease III: Medical Management
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:30Venous Thrombosis IV: Nursing Management
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...