24 June 2019 : Clinical Research
Control of Anticoagulation Therapy in Patients with Atrial Fibrillation Treated with Warfarin: A Study from the Chinese Atrial Fibrillation RegistryHai-Feng Liang12ABCDEF, Xin Du1ADEF, Ying-Chun Zhou3CD, Xiao-Yi Yang3BC, Shi-Jun Xia1BF, Jian-Zeng Dong1BDF, Gregory Y.H. Lip45ADEF, Chang-Sheng Ma1ABCEFG*
Med Sci Monit 2019; 25:4691-4698
BACKGROUND: Several factors determine the efficacy of warfarin anticoagulation in patients with non-valvular atrial fibrillation (NVAF). This study aimed to use data from the Chinese Atrial Fibrillation Registry study to assess the control of anticoagulation therapy in Chinese patients with NVAF treated with warfarin.
MATERIAL AND METHODS: From the Chinese Atrial Fibrillation Registry study the anticoagulant use and dosing, the time in therapeutic range (TTR) of the international normalized ratio (INR), and standard deviation of the observed INR values (SDINR), and their influencing factors were evaluated.
RESULTS: The median INR and SDINR were 2.04 (IQR 1.71–2.41) and 0.50 (IQR, 0.35–0.69), respectively. The median TTR was 51.7% (IQR, 30.6–70.1%) and only 25.1% had a TTR ≥70%. Age was ≥70 years (OR, 0.72; 95% CI, 0.55–0.94; P=0.015), bleeding history (OR 0.48; 95% CI, 0.23–0.89; P=0.029), the use of a single drug (OR, 0.62; 95% CI, 0.42–0.92; P=0.016), more than drug (OR, 0.60; 95% CI, 0.41–0.88; P=0.009), and lack of assessment of bleeding risk (OR, 0.72; 95% CI, 0.54–0.97; P=0.033) were associated with TTR <70% (INR 2.0–3.0). Coronary heart disease (CHD) and peripheral artery disease (PAD) (OR, 0.69; 95% CI, 0.52–0.90; P=0.007) and diabetes mellitus (OR, 0.79; 95% CI, 0.62–0.99; P=0.044) were associated with increased variability in INR (SDINR ≥0.5).
CONCLUSIONS: In Chinese patients with NVAF, warfarin anticoagulation was associated with lower TTR and less stable anticoagulation than in current guidelines, and risk factors for reduced safety and efficacy were identified.
Keywords: Anticoagulants, Atrial Fibrillation, Quality Control, Warfarin, Aged, Aged, 80 and over, Asians, Blood Coagulation, China, Hemorrhage, International Normalized Ratio, Male, Middle Aged, Registries, Retrospective Studies, Risk Factors, Stroke, Thrombolytic Therapy, Treatment Outcome
Most Viewed Current Articles
31 Dec 1969 : Original articleOutcome of 24 Weeks of Combined Schroth and Pilates Exercises on Cobb Angle, Angle of Trunk Rotation, Chest...
Med Sci Monit Basic Res 2020; 26:e920449
31 Dec 1969 : Original articleAnalysis of Psychological and Sleep Status and Exercise Rehabilitation of Front-Line Clinical Staff in the ...
Med Sci Monit Basic Res 2020; 26:e924085
31 Dec 1969 : Review articleA Southeast Asian Perspective on the COVID-19 Pandemic: Hemoglobin E (HbE)-Trait Confers Resistance Against...
Med Sci Monit Basic Res 2021; 27:e929207
31 Dec 1969 : Clinical ResearchEffects of Cognitive Task Training on Dynamic Balance and Gait of Patients with Stroke: A Preliminary Rando...
Med Sci Monit Basic Res 2020; 26:e925264