Effect of amiodarone on warfarin anticoagulation in patients after cardiac valve operation

Objective: To investigate the effect of amiodarone on warfarin anticoagulation in patients after cardiac valve operation. Methods: 200 patients, who underwent cardiac valve surgery in our hospital from August 2012 to August 2014, were retrospectively analyzed and divided into experiment group (100 cases) and control group (100 cases). The patients in control group were treated with warfarin alone after heart valve replacement; and patients in experiment group were treated with combined amiodarone on the treatment basis of control group. We compared the cumulative dose of warfarin in the first 5 days after operation, the time difference of INR entering into therapeutic window (1 week after surgery and the first entry), as well as the anticoagulation effect in 1 month after surgery between the two groups. Result: The cumulative dose of warfarin in the first 5 days after surgery in experiment group was lower than that of control group, the use of amiodarone did not affect the time of INR entering into therapeutic window (1 week after the surgery or first entry). The platelet count and APTT value of experimental group was significantly better than that of control group (palette count: (141 ± 40) 109/L vs. (131 ± 46) 109/L; APTT: (26 ± 4) vs. (20 ± 5)), the difference was statistically significant (P<0.05). The fibrin (3.11 ± 0.96) mg/dl, whole blood viscosity (4.08 ± 0.34) MPa-s, whole blood low shear viscosity (15.87 ± 4.49) MPa-s, blood cell volume (38.22 ± 5.27%) and plasma viscosity (1.35 ± 0.27) MPa-s of experiment group were lower than those of the control group (fibrin original: (4.53 ± 1.19) mg/dl; Whole blood viscosity: (5.86 ± 0.41) MPa-s; whole blood low shear viscosity: (19.26 ± 4.81) MPa-s; blood cell volume: (45.81 ± 5.09%); plasma viscosity: (2.16 ± 0.34) MPa-s), the difference was statistically significant (P<0.05). The incidence of complications in control group was 12.0%, which was significantly higher than 4.0% of the experiment group. Conclusion: Amiodarone combined with Warfarin anticoagulant therapy after cardiac valve surgery can reduce the dose of warfarin and the incidence of complications, thus it has important clinical significance.