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KMID : 0311120090500010083
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Yonsei Medical Journal
2009 Volume.50 No. 1 p.83 ~ p.88
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How Well Does the Target INR Level Maintain in Warfarin- Treated Patients with Non-ValvularAtrial Fibrillation?
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Kim Jun-Hyung
Choi Jin-Oh
Shin Dae-Hee
Kim June-Soo
Song Young-Bin
Kim Je-Sang
On Young-Kun
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Abstract
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Purpose: Although warfarin is an effective oral anticoagulation (OAC) drug to reduce the risk of thromboembolism in patients with non-valvular atrial fibrillation (NVAF), long term follow-up data are scarce to be certain whether the target INR level is maintained in warfarin-treated patients in Korea. The aim of this study was to evaluate how well INRs are maintained within the target range using a new index, INR stability (= 100 x number of INRs within target range/total number of INR measurements) which we made, and to find out any correlation between thromboembolic events and INR stability.
Materials and Methods: This study was an observational analysis of retrospectively collected data of 129 patients with NVAF from April 2000 to December 2005 at a single tertiary hospital. All patients were registered at the anticoagulation service.
Results: The median duration of follow up was 2.03 years (interquartile range 1.35-2.96). During the follow-up period, 60.9 ± 14.9% of the INR were within the target INR range. INR stability was not significantly different between patients without and with stroke (61.2 ± 15.0% vs 53.3 ± 4.9%). Among the known factors affecting fluctuations of the INR value, the most frequent factor was noncompliance (41.8%).
Conclusion: The present study showed that it was not enough to maintain INR values within the target range in warfarin-treated patients with NVAF even at a tertiary hospital. Noncompliance is an important problem which interferes with maintaining target INR range.
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KEYWORD
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Anticoagulation, atrial fibrillation
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