INR self-management following mechanical heart valve replacement

INR self-management can reduce severe thromboembolic and hemorrhagic compli cations following mechanical heart valve replacement. Beginning anticoagula tion therapy immediately in the postoperative period further reduces antico agulant-induced complications. Data were collected from the first 600 survi ving patients (from a total study sample of 1200 patients) who completed fo llow-up of at least 2 years. Patients were randomly divided into a selfmana gement group and a control group. INR selfmanagement reduced severe hemorrh agic and thromboembolic complications (P = 0.018). Nearly 80% of INR values recorded by patients themselves, regardless of educational level, were wit hin the target therapeutic range of INR 2.5-4.5, compared with 62% of INR v alues monitored by family practitioners. Only 8.3% of patients trained in s elf-management immediately after surgery were unable to continue with INR s elfmanagement. The results differed slightly between patient groups with di fferent levels of education. We conclude that all patients for whom anticoa gulation is indicated are candidates for INR self-management regardless of education level.