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Anticoagulation control among patients with nonvalvular atrial fibrillation: A single tertiary cardiac center experience
There is a limited knowledge about the predictors of anticoagulation control in patients with nonvalvular atrial fibrillation (NVAF). Furthermore, few reports addressed the role of time in therapeutic range (TTR) that could reflect the safety and efficacy of anticoagulation therapy. We aimed to asse...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5288964/ https://www.ncbi.nlm.nih.gov/pubmed/28217549 http://dx.doi.org/10.4103/2231-4040.197370 |
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author | Mohammed, Shaban Aljundi, Amer H. S. Kasem, Mohamed Alhashemi, Mohammed El-Menyar, Ayman |
author_facet | Mohammed, Shaban Aljundi, Amer H. S. Kasem, Mohamed Alhashemi, Mohammed El-Menyar, Ayman |
author_sort | Mohammed, Shaban |
collection | PubMed |
description | There is a limited knowledge about the predictors of anticoagulation control in patients with nonvalvular atrial fibrillation (NVAF). Furthermore, few reports addressed the role of time in therapeutic range (TTR) that could reflect the safety and efficacy of anticoagulation therapy. We aimed to assess factors that affect the quality of anticoagulation therapy utilizing TTR in patients with NVAF. A retrospective observational study was conducted for patients with NVAF who were maintained on warfarin >6 months at a tertiary cardiac care hospital. Patients were categorized according to the TTR status (≥65% vs. <65%). A total of 241 eligible patients were identified. A high-quality anticoagulation based on TTR values ≥65% was found in 157 (65.1%) patients; the remaining (34.9%) patients represented the low-quality anticoagulation group (TTR <65%). Demographics and clinical characteristics were comparable in the two TTR groups. Both groups were comparable in terms of warfarin dose and medications use. When compared to patients with high-quality anticoagulation, patients in the low-quality anticoagulation group were more likely to seek outpatient warfarin clinic visits more frequently (22.3 ± 5.5 vs. 18 ± 4.4, P = 0.001) and to have higher rate of polypharmacy (57.1% vs. 42%, P = 0.03). Of note, patients in both groups had similar major bleeding events (P = 0.41). After adjusting for age and sex, polypharmacy use was a predictor of poor coagulation control (odds ratio = 1.89, 95% confidence interval: 1.03–3.33; P = 0.03). In NVAF patients, TTR is generally high in our cohort. Patients with polypharmacy and frequent clinic visits have lower TTR. High-quality oral anticoagulation could be achieved through optimizing TTR without a significant risk of major bleeding. |
format | Online Article Text |
id | pubmed-5288964 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-52889642017-02-17 Anticoagulation control among patients with nonvalvular atrial fibrillation: A single tertiary cardiac center experience Mohammed, Shaban Aljundi, Amer H. S. Kasem, Mohamed Alhashemi, Mohammed El-Menyar, Ayman J Adv Pharm Technol Res Original Article There is a limited knowledge about the predictors of anticoagulation control in patients with nonvalvular atrial fibrillation (NVAF). Furthermore, few reports addressed the role of time in therapeutic range (TTR) that could reflect the safety and efficacy of anticoagulation therapy. We aimed to assess factors that affect the quality of anticoagulation therapy utilizing TTR in patients with NVAF. A retrospective observational study was conducted for patients with NVAF who were maintained on warfarin >6 months at a tertiary cardiac care hospital. Patients were categorized according to the TTR status (≥65% vs. <65%). A total of 241 eligible patients were identified. A high-quality anticoagulation based on TTR values ≥65% was found in 157 (65.1%) patients; the remaining (34.9%) patients represented the low-quality anticoagulation group (TTR <65%). Demographics and clinical characteristics were comparable in the two TTR groups. Both groups were comparable in terms of warfarin dose and medications use. When compared to patients with high-quality anticoagulation, patients in the low-quality anticoagulation group were more likely to seek outpatient warfarin clinic visits more frequently (22.3 ± 5.5 vs. 18 ± 4.4, P = 0.001) and to have higher rate of polypharmacy (57.1% vs. 42%, P = 0.03). Of note, patients in both groups had similar major bleeding events (P = 0.41). After adjusting for age and sex, polypharmacy use was a predictor of poor coagulation control (odds ratio = 1.89, 95% confidence interval: 1.03–3.33; P = 0.03). In NVAF patients, TTR is generally high in our cohort. Patients with polypharmacy and frequent clinic visits have lower TTR. High-quality oral anticoagulation could be achieved through optimizing TTR without a significant risk of major bleeding. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5288964/ /pubmed/28217549 http://dx.doi.org/10.4103/2231-4040.197370 Text en Copyright: © 2017 Journal of Advanced Pharmaceutical Technology & Research http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Mohammed, Shaban Aljundi, Amer H. S. Kasem, Mohamed Alhashemi, Mohammed El-Menyar, Ayman Anticoagulation control among patients with nonvalvular atrial fibrillation: A single tertiary cardiac center experience |
title | Anticoagulation control among patients with nonvalvular atrial fibrillation: A single tertiary cardiac center experience |
title_full | Anticoagulation control among patients with nonvalvular atrial fibrillation: A single tertiary cardiac center experience |
title_fullStr | Anticoagulation control among patients with nonvalvular atrial fibrillation: A single tertiary cardiac center experience |
title_full_unstemmed | Anticoagulation control among patients with nonvalvular atrial fibrillation: A single tertiary cardiac center experience |
title_short | Anticoagulation control among patients with nonvalvular atrial fibrillation: A single tertiary cardiac center experience |
title_sort | anticoagulation control among patients with nonvalvular atrial fibrillation: a single tertiary cardiac center experience |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5288964/ https://www.ncbi.nlm.nih.gov/pubmed/28217549 http://dx.doi.org/10.4103/2231-4040.197370 |
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