Safety and efficacy of warfarin in heart valve replacement / Abdullah Fadhil Fauzi

Warfarin is an oral anti-coagulant that reverses the effect of Vitamin K in the body. It is essentially a requirement for heart valve replacement patients. This study aims to assess the safety and efficacy of warfarin during the treatment by evaluating Time in Therapeutic Range of patients and their relationship to bleeding incidents and stroke. Results and Discussion: A total of 32 data of patients were collected retrospectively. In 28 patients, TTR were found to be outside its proposed range (<75%) with 11 of them experiencing bleeding incidents during warfarin treatment. Meanwhile, only two patients out of four with TTR >75% experienced bleeding. However, none of these patients experienced stroke. The most common cause of INR readings being out of range was found to be due to drug interaction and its side effects which can be observed in 12 patients. On the other hand, the cause was undetermined in three patients. Conclusion: It would be challenging to maintain TTR at >75% as warfarin therapy requires discipline and commitment from patients. No cases of stroke was recorded. The safety is also proven provided that good patient management is practiced between the patient, caregiver and prescriber.