机构:[1]Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, P.R. China临床科室心脏内科中心首都医科大学附属安贞医院[2]Department of Cardiology, Fuxing Hospital, Capital Medical University, Beijing, P.R. China[3]East China Normal University, Shanghai, P.R. China[4]Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom[5]Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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/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.
基金:
Ministry of Science and Technology of the People's Republic of ChinaMinistry of Science and Technology, China [2013BAI09B02, 2013DFB30310]; Beijing Municipal Commission of Science and Technology [D111100003011004, D131100002313001]; Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support [ZYLX201302]; Bristol-Myers SquibbBristol-Myers Squibb; PfizerPfizer; Johnson JohnsonJohnson & Johnson USA; Boehringer IngelheimBoehringer Ingelheim; BayerBayer AG
第一作者机构:[1]Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, P.R. China[2]Department of Cardiology, Fuxing Hospital, Capital Medical University, Beijing, P.R. China
通讯作者:
通讯机构:[1]Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, P.R. China
推荐引用方式(GB/T 7714):
Hai-Feng Liang,Xin Du,Ying-Chun Zhou,et al.Control of Anticoagulation Therapy in Patients with Atrial Fibrillation Treated with Warfarin: A Study from the Chinese Atrial Fibrillation Registry[J].MEDICAL SCIENCE MONITOR.2019,25:4691-4698.doi:10.12659/MSM.917131.
APA:
Hai-Feng Liang,Xin Du,Ying-Chun Zhou,Xiao-Yi Yang,Shi-Jun Xia...&Chang-Sheng Ma.(2019).Control of Anticoagulation Therapy in Patients with Atrial Fibrillation Treated with Warfarin: A Study from the Chinese Atrial Fibrillation Registry.MEDICAL SCIENCE MONITOR,25,
MLA:
Hai-Feng Liang,et al."Control of Anticoagulation Therapy in Patients with Atrial Fibrillation Treated with Warfarin: A Study from the Chinese Atrial Fibrillation Registry".MEDICAL SCIENCE MONITOR 25.(2019):4691-4698