24 June 2019 : Clinical Research
Control of Anticoagulation Therapy in Patients with Atrial Fibrillation Treated with Warfarin: A Study from the Chinese Atrial Fibrillation Registry
Hai-Feng Liang12ABCDEF, Xin Du1ADEF, Ying-Chun Zhou3CD, Xiao-Yi Yang3BC, Shi-Jun Xia1BF, Jian-Zeng Dong1BDF, Gregory Y.H. Lip45ADEF, Chang-Sheng Ma1ABCEFG*DOI: 10.12659/MSM.917131
Med Sci Monit 2019; 25:4691-4698
Abstract
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, 80 and over, Asians, Blood Coagulation, Hemorrhage, International Normalized Ratio, Registries, Risk Factors, Stroke, Thrombolytic Therapy
Editorial
01 June 2024 : Editorial
Editorial: Concerns as Highly Pathogenic Avian Influenza (HPAI) Virus of the H5N1 Subtype is Identified in Dairy Cows and Other MammalsDOI: 10.12659/MSM.945315
Med Sci Monit 2024; 30:e945315
In Press
Clinical Research
Determining the Optimal Dosage of Dexmedetomidine for Smooth Emergence in Older Patients Undergoing Spinal ...Med Sci Monit In Press; DOI: 10.12659/MSM.944427
Clinical Research
Enhancement of Motor Learning and Corticospinal Excitability: The Role of Electroacupuncture and Motor Trai...Med Sci Monit In Press; DOI: 10.12659/MSM.943748
Animal Research
The Impact of Repeated Steam Sterilization Cycles on the Efficacy of Chairside Adjustment Kits for Polishin...Med Sci Monit In Press; DOI: 10.12659/MSM.944502
Clinical Research
Development and Evaluation of the Italian Version of the Dichotic Digit Test: Insights from 39 Normal-Heari...Med Sci Monit In Press; DOI: 10.12659/MSM.944090
Most Viewed Current Articles
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952