Anticoagulation and prosthetic heart valves: To the Editor [Reply]

To the Editor: The work of Saour et al. on anticoagulation in patients with prosthetic heart valves (Feb. 15 issue)¹ is to be commended for its attempt to address the problem of the appropriate intensity of anticoagulation in such patients. The authors concluded that “moderate-intensity” anticoagulation with coumadin (prothrombin-time ratio, 1.3 to 1.7) is associated with no greater frequency of thromboembolic events than “high-intensity” anticoagulation (prothrombin-time ratio, 2.3 to 2.7), but with fewer hemorrhagic complications. However, the data for thromboembolic events shown in Figure 1 of their paper suggest an entirely different conclusion. If the embolic data are analyzed in.