الفهرس Only 14 pages are availabe for public view
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Abstract
Background: Patients with mechanical heart valves are at high risk for thromboembolic events, necessitating the use of vitamin K antagonists (VKAs). Thrombotic and embolic complications and anticoagulation-related bleeding are by far the most prevalent contributors to morbidity and mortality after surgery for valvular heart diseases so require lifelong oral anticoagulant therapy. The quality of anticoagulation control, as reflected by the average individual time in therapeutic range (TTR) is a major determinant of efficacy and safety of the VKAs. Objective: The aim of this study is to identify the pattern of use of oral anticoagulants after prosthetic valve replacement at Kasr Al-Ainy Hospital.Assess patients’ adherence, knowledge and satisfaction with OAC therapy. Methods: This is a prospective observational study, Data was collected through face-to-face interview method using oral Anti-Clot Treatment Scale (ATCS) to measure satisfaction and the 4-items Morisky Scale to measure adherence to therapy, in addition clinical background characteristic was taken.Also the surgical history as regard date of surgery, type and location of valves replaced, any previous bleeding or thrombotic complications and average dose of warfarin controlling INR level. During follow up assessed dose requirement, INR and adverse events. Data was processed using SPSS23. Logistic regression analysis was performed. P value <0.05 was considered statistically significant. Results: This study enrolled 67 patients with mechanical prosthetic heart valve the mean age was (39.25±11.38) years, female account for 71.6% of the study group. We had a low Time in Therapeutic range (TTR) with a mean of 45.2% (± 32.4), low rate of adherence (13.4%) to OAC treatment, (65.7%) of thepatientswere considered as had adequate knowledge and about half were satisfied with OACs. More 61% of the patients use ASA in addition to VKA but we didn’t find correlation with complications. Good educational level associated with better knowledge and satisfaction with OAC treatment