A patient with a mechanical heart valve needs to receive antithrombotic therapy.
(1) aspirin 75 to 100 mg per day (an alternative agent is needed if there is aspirin intolerance)
(2) life-long warfarin therapy
Indications for targeting an INR of 2.5 to 3.5:
(1) mechanical mitral valve
(2) aortic caged ball or tilting disc
(3) (aortic bileaflet or Medtronic Hall) plus risk factors (see below)
Indications for targeting an INR of 2.0 to 3.0:
(1) (aortic bileaflet or Medtronic Hall) without risk factors
(1) atrial fibrillation
(2) history of a thromboembolism
(3) left ventricular ejection fraction < 35%
(4) hypercoagulable state
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Specialty: Hematology Oncology, Clinical Laboratory, Clinical Pharmacology