{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:58:52Z","timestamp":1790355532289,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T00:00:00Z","timestamp":1582156800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Quality of warfarin therapy in patients with a mechanical prosthetic heart valve (MPHV) has been barely investigated. We analysed determinants of low time in the therapeutic range (TiTR &lt;60%) in 2111 patients with MPHVs from the nationwide PLECTRUM study by the Italian Federation of Anticoagulation Clinics. Overall, 48\u00b75% of patients had a TiTR of &lt;\u00a060%. At logistic regression analysis, arterial hypertension (odds ratio [OR] 1\u00b7502, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001), diabetes (OR 1\u00b7732, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001), heart failure (OR 1\u00b7484, <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7004), mitral site (vs. aortic) (OR 1\u00b7399, <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7006), international normalised ratio (INR) ranges of 2\u00b75\u20133\u00b75 (OR 2\u00b7575, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001) and 3\u00b70\u20134\u00b70 (OR 8\u00b7215, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001) associated with TiTR &lt;\u00a060%. TiTR is substantially suboptimal in MPHV patients, particularly in higher INR ranges.<\/jats:p>","DOI":"10.1111\/bjh.16528","type":"journal-article","created":{"date-parts":[[2020,2,21]],"date-time":"2020-02-21T03:53:30Z","timestamp":1582257210000},"page":"588-593","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Determinants of low\u2010quality warfarin anticoagulation in patients with mechanical prosthetic heart valves. The nationwide PLECTRUM study"],"prefix":"10.1111","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6357-5213","authenticated-orcid":false,"given":"Daniele","family":"Pastori","sequence":"first","affiliation":[{"name":"I Clinica Medica Atherothrombosis Centre Department of Clinical Internal, Anaesthetic and Cardiovascular Sciences Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science University of Liverpool and Liverpool Heart &amp; Chest Hospital Liverpool UK"},{"name":"Aalborg Thrombosis Research Unit Department of Clinical Medicine Aalborg University Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Poli","sequence":"additional","affiliation":[{"name":"Thrombosis Centre Azienda Ospedaliero\u2010Universitaria Careggi Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"Antonucci","sequence":"additional","affiliation":[{"name":"Arianna Anticoagulazione Foundation Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Rubino","sequence":"additional","affiliation":[{"name":"I Clinica Medica Atherothrombosis Centre Department of Clinical Internal, Anaesthetic and Cardiovascular Sciences Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Menichelli","sequence":"additional","affiliation":[{"name":"I Clinica Medica Atherothrombosis Centre Department of Clinical Internal, Anaesthetic and Cardiovascular Sciences Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirella","family":"Saliola","sequence":"additional","affiliation":[{"name":"I Clinica Medica Atherothrombosis Centre Department of Clinical Internal, Anaesthetic and Cardiovascular Sciences Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Violi","sequence":"additional","affiliation":[{"name":"I Clinica Medica Atherothrombosis Centre Department of Clinical Internal, Anaesthetic and Cardiovascular Sciences Sapienza University of Rome Rome Italy"},{"name":"Mediterranea Cardiocentro Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gualtiero","family":"Palareti","sequence":"additional","affiliation":[{"name":"Arianna Anticoagulazione Foundation Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Pignatelli","sequence":"additional","affiliation":[{"name":"I Clinica Medica Atherothrombosis Centre Department of Clinical Internal, Anaesthetic and Cardiovascular Sciences Sapienza University of Rome Rome Italy"},{"name":"Mediterranea Cardiocentro Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Italian Federation of Anticoagulation Clinics 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