De Ritis ratio as a significant prognostic factor of international normalized ratio ≥4 in the initial 10 days of warfarin therapy

Biomark Med. 2019 Dec;13(18):1599-1607. doi: 10.2217/bmm-2019-0033. Epub 2019 Oct 29.

Abstract

Aim: To assess the relationship between the De Ritis ratio on admission and warfarin sensitivity in the initial 10 days of anticoagulation therapy. Methods: We retrospectively reviewed data from 906 patients who underwent heart valve replacement surgery. Results: A De Ritis ratio of 1.19 was identified as the optimal cutoff according to the ROC curve. Patients with a high De Ritis ratio achieved an international normalized ratio (INR) ≥4 more easily and earlier than those with a low De Ritis ratio in the initial 10 days of warfarin therapy. Multivariate analysis showed that a high De Ritis ratio was an independent predictor of an INR ≥4 (HR: 2.567; p < 0.001). Conclusion: A De Ritis ratio ≥1.19 on admission was significantly associated with an INR ≥4 in the initial 10 days of warfarin therapy among patients underwent heart valve replacement surgery.

Keywords: De Ritis ratio; INR; heart valve replacement surgery; warfarin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anticoagulants / administration & dosage*
  • Disease-Free Survival
  • Female
  • Heart Valve Diseases / blood
  • Heart Valve Diseases / diagnosis
  • Heart Valve Diseases / drug therapy*
  • Heart Valve Diseases / mortality
  • Heart Valves / surgery
  • Humans
  • International Normalized Ratio
  • Male
  • Middle Aged
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Warfarin / administration & dosage*

Substances

  • Anticoagulants
  • Warfarin