Evaluation of Prothrombin Time and Activated Partial Thromboplastin Time in Antithrombotic-Treated Cardiac Patients: A Cross-Sectional Study from Sana'a City, Yemen.
Amer A, Al-Adhroey A, Al-Shammakh A • Vascular health and risk management • 2026
Coagulation profiles in cardiovascular patients vary significantly according to both the underlying cardiac diagnosis and the type of antithrombotic therapy, with MVR and RHD patients displaying notably elevated parameters, underscoring the need for diagnosis-specific monitoring strategies in a Yemeni population.
Key Findings
Results
Coagulation parameters (PT, INR, APTT) varied significantly across cardiac diagnoses in antithrombotic-treated cardiovascular patients.
Cross-sectional study of 200 cardiovascular patients on antithrombotic therapy at selected hospitals in Sana'a City between January and March 2024.
Statistical significance was found for PT, INR, and APTT across diagnostic groups (p <0.01 for all three parameters).
Kruskal-Wallis and Mann-Whitney U-tests with Bonferroni correction for multiple comparisons were used.
The study population was predominantly male (69.0%) and aged 51-80 years (57.0%).
Results
Patients with Mitral Valve Replacement (MVR) had the highest median PT and INR values among all cardiac diagnosis groups.
MVR patients had the highest median PT of 36.45 seconds and median INR of 2.75.
Post-hoc analysis confirmed MVR patients had significantly elevated parameters compared to other groups.
MVR patients had a PT that was 19.01 seconds higher than STEMI patients (p=0.003).
These findings reflect the expected anticoagulation requirements for mechanical valve replacement.
Results
Rheumatic Heart Disease (RHD) patients showed intermediate PT elevation compared to other cardiac diagnosis groups.
RHD patients displayed PT values between those of MVR patients (highest) and ACS patients.
This intermediate elevation was identified through post-hoc analysis following the significant Kruskal-Wallis test result.
RHD was among the cardiac diagnoses included in the cross-sectional comparison.
Results
No significant differences in coagulation parameters were found between STEMI and Non-ST-segment Elevation Acute Coronary Syndrome (NSTE-ACS) subtypes.
STEMI and NSTE-ACS patients showed similar coagulation profiles despite being distinct ACS subtypes.
Post-hoc comparisons using Bonferroni correction did not identify significant differences between these two groups.
Both ACS subtypes had lower coagulation parameter values compared to MVR patients, with PT 19.01 seconds lower in STEMI versus MVR (p=0.003).
Results
The type of antithrombotic therapy significantly influenced coagulation parameters, with warfarin-treated patients showing the highest values.
Warfarin patients had the highest median PT (20.00s), INR (1.53), and APTT (40.00s) compared to other antithrombotic agents (p<0.05).
Dosage analysis confirmed warfarin's significant impact on coagulation parameters compared to aspirin doses.
These findings confirm the expected pharmacological effects of different antithrombotic agents.
Background
Antithrombotic therapy monitoring data from resource-limited settings like Yemen are scarce, representing a gap this study addresses.
The study was conducted in Sana'a City, Yemen, described as a resource-limited setting.
Data collection occurred between January and March 2024 at selected hospitals.
Demographic, clinical, and therapeutic data were collected alongside coagulation parameters.
The authors note findings underscore the need for diagnosis-specific monitoring strategies in this population.
Amer A, Al-Adhroey A, Al-Shammakh A. (2026). Evaluation of Prothrombin Time and Activated Partial Thromboplastin Time in Antithrombotic-Treated Cardiac Patients: A Cross-Sectional Study from Sana'a City, Yemen.. Vascular health and risk management. https://doi.org/10.2147/VHRM.S587006