American College of Clinical Pharmacy
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  Poster Hall

Sun-18 - Characterization of Warfarin Initiation after Mechanical Valve Replacement

Scientific Poster Session II - Original Research

Original Research
  Sunday, October 13, 2024
  12:45 PM–02:15 PM

Abstract

Introduction: Warfarin is the only guideline recommended anticoagulant indicated for mechanical valve replacement. There is an exaggerated response to warfarin in the early post-operative setting which leads to difficulty managing warfarin dosing.

Research Question or Hypothesis: The purpose of this study is to assess the relationship between warfarin initiation dose and warfarin interruption after mechanical valve replacement at Virginia Commonwealth University Health System (VCUHS).

Study Design: Single-center, retrospective chart review for quality improvement of VCUHS current guidance on warfarin initiation

Methods: This study included adult patients started on warfarin after mechanical heart valve at VCUHS from January 1, 2015 to June 30, 2023. Patients were divided into two groups; conservative initial warfarin dose <2.5 mg (n=92) and standard initial dose >2.5 mg (n=91). The primary composite outcome was the incidence of warfarin interruption attributed to supratherapeutic INR, rapid-rise INR, or bleeding. Other assessments included time to therapeutic range, hospital length of stay, and discharge warfarin dose. An independent t-test was used for analysis of continuous data and chi-squared or Fisher’s Exact for categorical data.

Results: There was no statistical difference in the composite outcome between groups. Warfarin interruption secondary to a rapid-rise INR occurred significantly more in the standard group (n=17) vs. conservative group (n=28), p=0.05. Overall, more patients in the standard group experienced supratherapeutic and rapid-rise INRs. Patients who received a conservative dose were more likely to have a longer time to therapeutic range but no difference in hospital length of stay. The average dose at discharge was 4 mg in both groups. In a subgroup analysis of the standard group, patients with cardiopulmonary bypass (CPB) =150 minutes were more like to meet the primary endpoint compared to those with CPB <150 minutes.

Conclusion: We recommend a standard initial warfarin dose of 4 mg and a conservative initial dose in patients with prolonged CPB (=150 minutes) at VCUHS.

Presenting Author

Leah Baker PharmD
Virginia Commonwealth University Health System

Authors

Cassandra Baker PharmD
Virginia Commonwealth University Health System

Kenneth Potter MD
Virginia Commonwealth University Health System