The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR
Yıl: 2016 Cilt: 16 Sayı: 8 Sayfa Aralığı: 595 - 600 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022
The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR
Öz: Objective: The awareness, time in therapeutic range (TTR), and safety of warfarin therapy were investigated in the adult Turkish population.Methods: This multicenter prospective study includes 4987 patients using warfarin and involved regular international normalized ratio (INR) monitoring between January 1, 2014 and December 31, 2014. TTR was calculated according to F.R. Roosendaal's algorithm. Awareness was evaluated based on the patients' knowledge of warfarin's affect and food-drug interactions.Results: The mean TTR of patients was 49.52±22.93%. The patients with hypertension (55.3%), coronary artery disease (23.2%), congestive heart failure (24.5%), or smoking habit (20.8%) had significantly lower TTR levels than the others. Of the total number of patients, 42.6% had a mechanical valve, 38.4% had non-valvular atrial fibrillation (AF), and 19% had other indications for warfarin. Patients with other indications had lower TTR levels than those with mechanical valve and non-valvular AF (p=0.018). Warfarin awareness decreased in higher age groups. The knowledge of warfarin's food-drug interactions was 55%. People with higher warfarin awareness had higher TTR levels. Patients with <=8 INR monitoring/year had lower TTR levels (46.4±25.3 vs. 51.1±21.3, respectively, p<0.001) and lower awareness (44.6% vs. 60.6%, p<0.001) than patients with >=8 INR monitoring/year. In this study, 20.1% of the patients had a bleeding event (major bleeding 15.8%, minor bleeding 84.2%) within a year. Conclusion: Both the mean TTR ratios and awareness of the Turkish population on warfarin therapy were found to be low. It was thought that low TTR levels of the Turkish population may be caused by the low awareness of warfarin, warfarin's food-drug interactions, and high rates of concomitant diseases.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- Horton JD, Bushwick BM. Warfarin therapy: evolving strategies in anticoagulation. Am Fam Physician 1999; 59: 635-46.
- Ansell J, Hirsh J, Hylek E, Jacobson A, Crowther M, Palareti G; American College of Chest Physicians. Pharmacology and man- agement of the vitamin K antagonists: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edi- tion) Chest 2008; 133: 160S-98S.
- Jones M, McEwan P, Morgan CL, Peters JR, Goodfellow J, Currie CJ. Evaluation of the pattern of treatment, level of anticoagulation control, and outcome of treatment with warfarin in patients with non-valvar atrial fibrillation: a record linkage study in a large British population. Heart 2005; 91: 472-7.
- 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 nor- malised ratio control for stroke prevention in atrial fibrillation: an analysis of the RE-LY trial. Lancet 2010; 376: 975-83.
- Connolly SJ, Pogue J, Eikelboom J, Flaker G, Commerford P, Franzosi MG, et al. ACTIVE W Investigators. Benefit of oral anticoagulant over antiplatelet therapy in atrial fibrillation depends on the quality of international normalized ratio control achieved by centers and countries as measured by time in therapeutic range. Circulation 2008; 118: 2029-37.
- White HD, Gruber M, Feyzi J, Kaatz S, Tse HF, Husted S, et al. Com- parison of outcomes among patients randomized to warfarin thera- py according to anticoagulant control: results from SPORTIF III and V. Arch Intern Med 2007; 167: 239-45.
- Rosendaal FR, Cannegieter SC, van der Meer FJ, Briet E. A method to determine the optimal intensity of oral anticoagulant therapy. Thromb Haemost 1993; 69: 236-9.
- Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schuünemann HJ; American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel. Executive summary: Antithrom- botic Therapy and Prevention of Thrombosis, 9th ed: American Col- lege of Chest Physicians Evidence-Based Clinical Practice Guide- lines. Chest 2012; 141(2 Suppl): 7S-47S.
- Pengo V, Pegoraro C, Cucchini U, Iliceto S. Worldwide management of oral anticoagulant therapy: the ISAM study. J Thromb Throm- bolysis 2006; 21: 73-7.
- Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, et al. ESC Committee for Practice Guidelines (CPG). 2012 focused update of the ESC Guidelines for the management of atrial fibril- lation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J 2012; 33: 2719-47.
- January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, et al. American College of Cardiology/American Heart As- sociation Task Force on Practice Guidelines. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart As- sociation Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2014; 64: e1-76.
- Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, et al. Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2014; 35: 3033-69.
- Kernan WN, Ovbiagele B, Black HR, Bravata DM, Chimowitz MI, Ezekowitz MD, et al. American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Peripheral Vascular Disease. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45: 2160-236.
- Ertaş F, Kaya H, Yüksel M, Soydinç MS, Alan S, Ülgen MS. Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER) study design. Anadolu Kardiyol Derg 2013; 13: 339-43.
- Ertaş F, Kaya H, Kaya Z, Bulur S, Köse N, Gül M, et al. Epidemiology of atrial fibrillation in Turkey: preliminary results of the multicenter AFTER study. Turk Kardiyol Dern Ars 2013; 41: 99-104.
- Karaçağlar E, Atar I, Yetiş B, Corut H, Ersoy B, Yılmaz K, et al. The frequency of embolic risk factors and adequacy of anti- embolic treatment in patients with atrial fibrillation: a single tertiary center experience. Anadolu Kardiyol Derg 2012; 12: 384-90.
- Ertaş F, Duygu H, Acet H, Eren NK, Nazlı C, Ergene AO. Oral antico- agulant use in patients with atrial fibrillation. Turk Kardiyol Dern Ars 2009; 37: 161-7.
- Pokorney SD, Simon DN, Thomas L, Fonarow GC, Kowey PR, Chang P, et al. Patients' time in therapeutic range on warfarin among US patients with atrial fibrillation: Results from ORBIT-AF registry. Am Heart J 2015; 170: 141-8.
- Lindh JD, Andersson ML, Mannheimer B. Adherence to guidelines for avoiding drug interactions associated with warfarin-a Nation- wide Swedish Register Study. PLoS One 2014; 9: e97388.
| APA | ÇELİK A, İzci S, kobat m, ATEŞ A, ÇAKMAK A, ÇAKILLI Y (2016). The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR. , 595 - 600. |
| Chicago | ÇELİK Ahmet,İzci Servet,kobat mehmet ali,ATEŞ AHMET HAKAN,ÇAKMAK Abdülkadir,ÇAKILLI Yasin The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR. (2016): 595 - 600. |
| MLA | ÇELİK Ahmet,İzci Servet,kobat mehmet ali,ATEŞ AHMET HAKAN,ÇAKMAK Abdülkadir,ÇAKILLI Yasin The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR. , 2016, ss.595 - 600. |
| AMA | ÇELİK A,İzci S,kobat m,ATEŞ A,ÇAKMAK A,ÇAKILLI Y The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR. . 2016; 595 - 600. |
| Vancouver | ÇELİK A,İzci S,kobat m,ATEŞ A,ÇAKMAK A,ÇAKILLI Y The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR. . 2016; 595 - 600. |
| IEEE | ÇELİK A,İzci S,kobat m,ATEŞ A,ÇAKMAK A,ÇAKILLI Y "The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR." , ss.595 - 600, 2016. |
| ISNAD | ÇELİK, Ahmet vd. "The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR". (2016), 595-600. |
| APA | ÇELİK A, İzci S, kobat m, ATEŞ A, ÇAKMAK A, ÇAKILLI Y (2016). The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR. The Anatolian Journal of Cardiology, 16(8), 595 - 600. |
| Chicago | ÇELİK Ahmet,İzci Servet,kobat mehmet ali,ATEŞ AHMET HAKAN,ÇAKMAK Abdülkadir,ÇAKILLI Yasin The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR. The Anatolian Journal of Cardiology 16, no.8 (2016): 595 - 600. |
| MLA | ÇELİK Ahmet,İzci Servet,kobat mehmet ali,ATEŞ AHMET HAKAN,ÇAKMAK Abdülkadir,ÇAKILLI Yasin The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR. The Anatolian Journal of Cardiology, vol.16, no.8, 2016, ss.595 - 600. |
| AMA | ÇELİK A,İzci S,kobat m,ATEŞ A,ÇAKMAK A,ÇAKILLI Y The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR. The Anatolian Journal of Cardiology. 2016; 16(8): 595 - 600. |
| Vancouver | ÇELİK A,İzci S,kobat m,ATEŞ A,ÇAKMAK A,ÇAKILLI Y The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR. The Anatolian Journal of Cardiology. 2016; 16(8): 595 - 600. |
| IEEE | ÇELİK A,İzci S,kobat m,ATEŞ A,ÇAKMAK A,ÇAKILLI Y "The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR." The Anatolian Journal of Cardiology, 16, ss.595 - 600, 2016. |
| ISNAD | ÇELİK, Ahmet vd. "The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR". The Anatolian Journal of Cardiology 16/8 (2016), 595-600. |
