Survey the Prevalence of Complications of Warfarin and to Determine their Relationship with Some Individual and Environmental Factors in Heart Valve Replacement Patients

Oral anticoagulants are frequently prescribed to decrease the tendency for thrombosis and embolism in susceptible individuals such as patients who underwent heart valve replacement. These components may have side effects sometimes intensify by individual and environmental factors. To investhgate the prevalence of complications of Warfarin and to determine their relationship with some individual and environmental factors in heart valve replacement patients in Guilan. This descriptive study was conducted through a prospective plan during May 2008- January 2009. The sample consists of 104 patients who underwent heart valve replacement, living across the Guilan proviance. Data were collected via a questionnaires completed by patients and results of blood test measured International Normalized Ratio (INR) Data were analyzed in SPSS using orderd regression logistic statistical method and chi- Square test. Among 936 collected records in nine stages of sampling, 56 cases (6%) showed moderate and severe increase in INR, women 1.85 times more likely to have increased INR. Among 38 cases of bleeding, 32(80%) occurred in this group of Patients, and the probability of bleeding in females was quite large (3.35). Among the factors included in this study, garlic, digestive tract medications and pain killers more likely intensify the anticoagulation effects of warfarin, increase the INR range and bleeding. On the contrary, consumption of soya, oil and cigarette smoking attenuate the drug effects on INR. With regard to results of this study that showed the effect of individual and environmental factors on warfarin therapeutic and adverse effects, it is recommended that patients underwent heart valve replacement and other user of this drug should receive necessary training and warnings.