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논문 기본 정보

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저자정보
Ki Hong Lee (Chonnam National University Hospital) Jeong Gwan Cho (Chonnam National University Hospital) Nuri Lee (Chonnam National University Hospital) 조경훈 (전남대학교병원) Hyung Ki Jeong (Chonnam National University Hospital) Hyukjin Park (Chonnam National University Hospital) Yongcheol Kim (Chonnam National University Hospital) Jae Yeong Cho (Chonnam National University Hospital) 김민철 (Chonnam National University Hospital) Doo Sun Sim (Chonnam National University Hospital) Hyun Ju Yoon (Chonnam National University Hospital) Nam Sik Yoon (Chonnam National University Hospital) Kye Hun Kim (Chonnam National University Hospital) Young Joon Hong (Chonnam National University Hospital) Hyung Wook Park (Chonnam National University Hospital) Youngkeun Ahn (Chonnam National University Hospital) Myung Ho Jeong (Chonnam National University Hospital) Jong Chun Park (Chonnam National University Hospital)
저널정보
대한심장학회 Korean Circulation Journal Korean Circulation Journal Vol.50 No.2
발행연도
2020.1
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163 - 175 (13page)

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Background and Objectives: Although anticoagulation with warfarin is recommended as an international normalized ratio (INR) of prothrombin time between 2.0 and 3.0 and mean time in the therapeutic range (TTR) ≥70%, little has been proven that universal criteria might be suitable in Korean atrial fibrillation (AF) patients. Methods: We analyzed 710 patients with non-valvular AF who took warfarin. INR value and clinical outcomes were assessed during 2-year follow-up. Intensity of anticoagulation was assessed as mean INR value and TTR according to target INR range. Primary net-clinical outcome was defined as the composite of new-onset stroke and major bleeding. Secondary net-clinical outcome was defined as the composite of new-onset stroke, major bleeding and death. Results: Thromboembolism was significantly decreased when mean INR was over 1.6. Major bleeding was significantly decreased when TTR was over 70% and mean INR was less than 2.6. Mean INR 1.6–2.6 significantly reduced thromboembolism (adjusted hazard ratio [HR], 0.40; 95% confidence interval [CI], 0.19–0.85), major bleeding (HR, 0.43; 95% CI, 0.23–0.81), primary (HR, 0.50; 95% CI, 0.29–0.84) and secondary (HR, 0.45; 95% CI, 0.28–0.74) net-clinical outcomes, whereas mean INR 2.0–3.0 did not. Simultaneous satisfaction of mean INR 1.6–2.6 and TTR ≥70% was associated with significant risk reduction of major bleeding, primary and secondary net-clinical outcomes. Conclusions: Mean INR 1.6–2.6 was better than mean INR 2.0–3.0 for the prevention of thromboembolism and major bleeding. However, INR 1.6–2.6 and TTR ≥70% had similar clinical outcomes to INR 2.0–3.0 and TTR ≥70% in Korean patients with non-valvular AF.
#Warfarin #Prothrombin time #Atrial fibrillation #Thromboembolism #Safety

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참고문헌 (27)

참고문헌 신청
Kirchhof P / 2016 / 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS / Eur Heart J 37:2893~2962 google schola January CT / 2014 / 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation : a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society / Circulation 130:e199~267 google schola JCS Joint Working Group / 2014 / Guidelines for pharmacotherapy of atrial fibrillation(JCS 2013) / Circ J 78:1997~2021 google schola You JH / 2005 / Is INR between 2.0 and 3.0 the optimal level for Chinese patients on warfarin therapy for moderate-intensity anticoagulation? / Br J Clin Pharmacol 59:582~587 google schola Chenhsu RY / 2000 / Long-term treatment with warfarin in Chinese population / Ann Pharmacother 34:1395~1401 google schola

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