Saliva to Monitor Warfarin Therapy after Prosthetic Heart Valve Replacement

Patients with prosthetic heart valve are in need of anticoagulant therapy for protection against thromboembolic events. Warfarin therapy is monitored by Prothrombin time (PT) and International Normalized Ratio (INR). The clotting assays are invasive and may carry infection and prosthetic valve endocarditis. We try to use human saliva as noninvasive diagnostic fluid to access anticoagulant state. Our study was done in Cardiothoracic Department in Ain Shams University Hospital on 132 Patients had prosthetic valve (MVR, AVR or DVR) and under Warfarin therapy. We measure salivary TF activity by Quick one stage method; then calculate TF activity ratio and TF activity log to 10. The therapeutic value of salivary TF ratio ranges from (2.23 to 3.60) and salivary TF log to 10 ranges from (2.364 to 2.560). There is strong positive correlation between both salivary TF ratio and salivary TF log to 10 with INR (2.00 to 3.50). Salivary TF activity ratio has wider range than TF log to 10, and needs each laboratory to make its control under standardized conditions. Thus, the measurement of salivary TF activity ratio is a reliable test for follow up of patients on oral anticoagulant therapy. [Ahmed Samy' Moshria H. Sabry' Abdelhady M. Hamada Saliva to Monitor Warfarin Therapy after Prosthetic Heart Valve Replacement. Life Sci J 2012;9(4):829-832] (ISSN:1097-8135). http://www.lifesciencesite.com. 129