Journals / İstanbul Kuzey Klinikleri / 2022 / Cilt: 9 - Sayı: 2

Which is the best for the warfarin monitoring: Following up by fixed or variable physician?

Pages
93–101
Publication Date
2022-10-18
DOI
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

During median 25.5 months (9–36) of follow-up, minor bleeding, major bleeding and cerebral embolic event rates were higher in VP group compared to SP group (p

📌 3 Key Takeaways

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Objective & Hypothesis:OBJECTIVE: Warfarin therapy has some difficulties in terms of close monitoring and dosage.
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Key Findings & Data:METHODS: A total of 625 consecutive patients requiring warfarin treatment were enrolled at seven centers.
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Conclusion & Impact:During median 25.5 months (9–36) of follow-up, minor bleeding, major bleeding and cerebral embolic event rates were higher in VP group compared to SP group (p
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

OBJECTIVE: Warfarin therapy has some difficulties in terms of close monitoring and dosage. This study aims to evaluate the effect of same-fixed versus different-variable physician-based monitoring of warfarin therapy on treatment quality and clinical end-points. METHODS: A total of 625 consecutive patients requiring warfarin treatment were enrolled at seven centers. INR values of the patients measured at each visit and registered to hospital database were recorded. Time in therapeutic range (TTR) was calculated using linear interpolation method (Rosendaal’s method). A TTR value of ≥65% was considered as effective warfarin treatment. If a patient was evaluated by the same-fixed physician at each INR visit, was categorized into the same-physician (SP) group. In contrast, if a patient was evaluated by different-variable physicians at each INR visit, was categorized into variable physician (VP) group. Enrolled patients were followed up for bleeding and embolic events. RESULTS: One hundred and fifty-six patients (24.9%) were followed by SP group, 469 (75.1%) patients were followed by VP group. Median TTR value of the VP group was lower than that of SP group (56.2% vs. 65.1%, respectively, p=0.009). During median 25.5 months (9–36) of follow-up, minor bleeding, major bleeding and cerebral embolic event rates were higher in VP group compared to SP group (p

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Cite This Article

YILMAZ, M. B., ŞEN, T., BETON, O., İPEK, E. G., KAFES, H., TEMİZHAN, A., ASARCIKLI, L. D. (2022). Which is the best for the warfarin monitoring: Following up by fixed or variable physician?. İstanbul Kuzey Klinikleri, Cilt: 9 - Sayı: 2, 93–101. https://ajindex.com/articles/551218

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References (11)

  1. Cavallari LH, Shin J, Perera MA. Role of pharmacogenomics in the management of traditional and novel oral anticoagulants. Pharmacotherapy 2011;31:1192–207
  2. Nieuwlaat R, Capucci A, Lip GY, Olsson SB, Prins MH, Nieman FH, et al; Euro Heart Survey Investigators. Antithrombotic treatment in real-life atrial fibrillation patients: a report from the Euro Heart Survey on Atrial Fibrillation. Eur Heart J 2006;27:3018–26
  3. European Heart Rhythm Association; European Association for Cardio-Thoracic Surgery, Camm AJ, Kirchhof P, Lip GY, Schotten U, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J 2010;31:2369–429
  4. Rosendaal FR, Cannegieter SC, van der Meer FJ, Briët E. A method to determine the optimal intensity of oral anticoagulant therapy. Thromb Haemost 1993;69:236–9
  5. Wallentin L, Yusuf S, Ezekowitz MD, Alings M, Flather M, Franzosi MG, et al; RE-LY investigators. Efficacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial fibrillation: an analysis of the RELY trial. Lancet 2010;376:975–83. 6. van Walraven C, Oake N, Wells PS, Forster AJ. Burden of potentially avoidable anticoagulant-associated hemorrhagic and thromboembolic events in the elderly. Chest 2007;131:1508–15
  6. Björck F, Sandén P, Renlund H, Svensson PJ, Själander A. Warfarin treatment quality is consistently high in both anticoagulation clinics and primary care setting in Sweden. Thromb Res 2015;136:216–20
  7. Jones C, Pollit V, Fitzmaurice D, Cowan C; Guideline Development Group. The management of atrial fibrillation: summary of updated NICE guidance. BMJ 2014;348:g3655
  8. Hicks KA, Stockbridge NL, Targum SL, Temple RJ. Bleeding Academic Research Consortium consensus report: the Food and Drug Administration perspective. Circulation 2011;123:2664–5
  9. Menke J, Lüthje L, Kastrup A, Larsen J. Thromboembolism in atrial fibrillation. Am J Cardiol 2010;105:502–10
  10. Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC); European Association for Cardio-Thoracic Surgery (EACTS), Vahanian A, Alfieri O, Andreotti F, Antunes MJ, et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J 2012;33:2451–96
  11. Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, et al; Task Fo