Patients with mechanical heart valves may benefit from managing their own blood thinners, a new study suggests.
“There are several reasons that patients who self-manage treatment have better outcomes than those who follow standard management,” said study leader Dr. Thomas Decker Christensen, from Aarhus University Hospital, in Denmark.
“Self-management patients receive more detailed information about oral anticoagulation therapy; they also learn more about the influence that diet, infectious diseases, alcohol, and other drug interactions can have on their treatment than do patients receiving standard management,” Christensen explained.
“We believe that the majority of patients who have a mechanical heart valve inserted during surgery should be able to manage their oral anticoagulant therapy, and recommend this as the standard treatment approach for these patients,” he concluded.
Patients with these heart valves must take blood thinners (such as warfarin) to prevent blood clots, which could lead to strokes.
The study included slightly more than 600 patients who received mechanical heart valves and then took a course to learn how to manage their own blood thinners, gradually transitioning to self-management over the next three to 27 weeks.
These patients were compared with a control group of about 3,000 patients who received standard blood thinner management.
One year after heart valve surgery, both groups were at similar risk for major bleeding and thromboembolism, a blood clot that forms in one location and then travels and blocks another blood vessel, the findings showed.
But after five years, those in the self-management group had a lower risk of death from all causes than those in the control group, according to the study published online Nov. 10 in The Annals of Thoracic Surgery.
“Once patients were approved for self-management, they were allowed to continue as such but could contact the treatment center with questions or concerns,” Christensen said in a journal news release.
“Patients were provided with a portable coagulometer, which they used to analyze medication levels and monitor dosage. Blood levels were measured and tracked weekly,” he said.
The U.S. National Heart, Lung, and Blood Institute has more about treatments for heart valve disease.