지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2009.1
- 수록면
- 515 - 523 (9page)
이용수
초록· 키워드
오류제보하기
Background : Warfarin is a widely used oral anticoagulant with broad within- and between-individual dose requirements. Warfarin concentrations can be monitored by assessing its pharmacologic effects on International Normalized Ratio (INR). However, this approach has not been applied in the routine clinical management of patients receiving warfarin therapy. We performed a plasma warfarin assay using high-performance liquid chromatography tandem mass spectrometry (HPLCMS/ MS) to determine if such an assay can be utilized in routine clinical practice.
Methods : We included a total of 105 patients with atrial fibrillation, and who were receiving warfarin for more than 1 yr. The plasma concentrations of total warfarin and 7-hydroxywarfarin were determined by HPLC-MS/MS (Waters, UK). We assessed the association between warfarin dose, concentration, and INR as well as the effects of these factors on warfarin concentrations.
Results : The mean maintenance dose of warfarin in 105 patients was 4.1±1.3 mg/day (range, 1.7-8.0 mg/day) and their mean plasma warfarin concentration was 1.3±0.5 mg/L. We defined a concentration range of 0.6-2.6 mg/L (corresponding to the 2.5th to 97.5th percentile range of the serum warfarin levels in the 74 patients showing INR within target range) as the therapeutic range for warfarin. The correlation of warfarin dose with warfarin concentration (r2=0.259, P<0.001) was higher than that with INR (r2=0.029, P=0.072).
Conclusions : There was a significant correlation between warfarin dose and plasma warfarin concentrations in Korean patients with atrial fibrillation. Hence, plasma warfarin monitoring can help determine dose adjustments and improve our understanding of individual patient response to warfarin treatment.
목차
등록된 정보가 없습니다.
참고문헌 (25)
참고문헌 신청
Bodin L / 2005 / A vitamin K epoxide reductase complex subunit-1 (VKORC1) mutation in a patient with vitamin K antagonist resistance / J Thromb Haemost 3 : 1533 ~ 1535
Burton ME / 2006 / Applied pharmacokinetics & pharmacodynamics: Principles of therapeutic drug monitoring. 4th ed / Lippincott Williams & Wilkins : 713 ~ 751
D'Ambrosio RL / 2007 / A new vitamin K epoxide reductase complex subunit-1 (VKORC1) mutation in a patient with decreased stability of CYP2C9 enzyme / J Thromb Haemost 5 : 191
Dericioglu N / 2004 / Warfarin resistance with poor CYP2C9 activity and CYP2C9*1*2 genotype / Ann Pharmacother 38 : 899 ~
Fang MC / 2006 / Age and the risk of warfarin-associated hemorrhage: the anticoagulation and risk factors in atrial fibrillation study / J Am Geriatr Soc 54 : 1231 ~ 1236
Burton ME / 2006 / Applied pharmacokinetics & pharmacodynamics: Principles of therapeutic drug monitoring. 4th ed / Lippincott Williams & Wilkins : 713 ~ 751
D'Ambrosio RL / 2007 / A new vitamin K epoxide reductase complex subunit-1 (VKORC1) mutation in a patient with decreased stability of CYP2C9 enzyme / J Thromb Haemost 5 : 191
Dericioglu N / 2004 / Warfarin resistance with poor CYP2C9 activity and CYP2C9*1*2 genotype / Ann Pharmacother 38 : 899 ~
Fang MC / 2006 / Age and the risk of warfarin-associated hemorrhage: the anticoagulation and risk factors in atrial fibrillation study / J Am Geriatr Soc 54 : 1231 ~ 1236
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