Potential factors affecting the anticoagulation control in patients treated with warfarin: Results WARFARIN-TR study

Background: In the present study, we aimed to evaluate the factors that might be caused by adequate anticoagulation control in patients treated with warfarin for any reason. Methods: The WARFARIN-TR (The Awareness, Efficacy, Safety, and Time in Therapeutic Range of Warfarin in Turkish Population) st...

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Main Authors: Salih Kilic, Ahmet Çelik, Ali Sabri Seyis, Ozge Kurmus, Kamil Tülüce, Zeynep Yapan Emren, Ali Kemal Kalkan, Mehdi Zoghi
Format: Article
Language:English
Published: Galenos Publishing House 2018-01-01
Series:International Journal of the Cardiovascular Academy
Subjects:
Online Access:http://www.ijcva.com/article.asp?issn=2405-8181;year=2018;volume=4;issue=4;spage=86;epage=89;aulast=Kilic
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author Salih Kilic
Ahmet Çelik
Ali Sabri Seyis
Ozge Kurmus
Kamil Tülüce
Zeynep Yapan Emren
Ali Kemal Kalkan
Mehdi Zoghi
author_facet Salih Kilic
Ahmet Çelik
Ali Sabri Seyis
Ozge Kurmus
Kamil Tülüce
Zeynep Yapan Emren
Ali Kemal Kalkan
Mehdi Zoghi
author_sort Salih Kilic
collection DOAJ
description Background: In the present study, we aimed to evaluate the factors that might be caused by adequate anticoagulation control in patients treated with warfarin for any reason. Methods: The WARFARIN-TR (The Awareness, Efficacy, Safety, and Time in Therapeutic Range of Warfarin in Turkish Population) study included 4987 patients using warfarin between January 1, 2014 and December 31, 2014. Time in therapeutic range (TTR) was calculated according to F. R. Roosendaal's algorithm with linear interpolation. The study population divided into two groups; adequate international normalized ratio (INR) control when TTR ≥70% (Group 1, n = 1068, 21.4%) and inadequate INR control when TTR <70% (Group 2, n = 3919, 78.6%). All demographic and clinic characteristics of the patients were compared to determine possible factors that might be cause adequate warfarin use. Results: The mean age of the study population was 60.7 ± 13.5 years, and there was no significant difference between groups. The mean TTR value of Group 1 was significantly higher than Group 2 (80 ± 8.5 vs. 40.9 ± 17.2; P < 0.001). The traditional cardiovascular risk factors were similar between groups except hypertension (Group 1 51.4% and Group 2 56.4%; P = 0.004) and chronic kidney disease (Group 1 8.3% and Group 2 5.5%; P = 0.001). There were no significant differences between groups regarding bleeding. The awareness of warfarin use was significantly higher in Group 1 patients than Group 2 patients. Multivariate logistic regression analysis revealed that age (odds ratio [OR], 1.007; P = 0.014), hypertension (OR, 0.821; P = 0.01), atrial fibrillation (OR, 1.180; P = 0.033), chronic kidney disease (OR, 1.697; P < 0.001), to know warfarin use reason (OR, 1.699; P < 0.001), and know to food-drug interaction with warfarin (OR, 1.583; P < 0.001) were independent predictors of adequate coagulation. Conclusion: Our study demonstrated that a low proportion of patients taking warfarin achieve an adequate TTR in daily practice. Furthermore, the patients with adequate TTR are more aware of warfarin use.
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spelling doaj.art-19c4407d108e41428063d4a66c7588d82023-09-03T04:06:02ZengGalenos Publishing HouseInternational Journal of the Cardiovascular Academy2405-81812405-819X2018-01-0144868910.4103/IJCA.IJCA_43_18Potential factors affecting the anticoagulation control in patients treated with warfarin: Results WARFARIN-TR studySalih KilicAhmet ÇelikAli Sabri SeyisOzge KurmusKamil TülüceZeynep Yapan EmrenAli Kemal KalkanMehdi ZoghiBackground: In the present study, we aimed to evaluate the factors that might be caused by adequate anticoagulation control in patients treated with warfarin for any reason. Methods: The WARFARIN-TR (The Awareness, Efficacy, Safety, and Time in Therapeutic Range of Warfarin in Turkish Population) study included 4987 patients using warfarin between January 1, 2014 and December 31, 2014. Time in therapeutic range (TTR) was calculated according to F. R. Roosendaal's algorithm with linear interpolation. The study population divided into two groups; adequate international normalized ratio (INR) control when TTR ≥70% (Group 1, n = 1068, 21.4%) and inadequate INR control when TTR <70% (Group 2, n = 3919, 78.6%). All demographic and clinic characteristics of the patients were compared to determine possible factors that might be cause adequate warfarin use. Results: The mean age of the study population was 60.7 ± 13.5 years, and there was no significant difference between groups. The mean TTR value of Group 1 was significantly higher than Group 2 (80 ± 8.5 vs. 40.9 ± 17.2; P < 0.001). The traditional cardiovascular risk factors were similar between groups except hypertension (Group 1 51.4% and Group 2 56.4%; P = 0.004) and chronic kidney disease (Group 1 8.3% and Group 2 5.5%; P = 0.001). There were no significant differences between groups regarding bleeding. The awareness of warfarin use was significantly higher in Group 1 patients than Group 2 patients. Multivariate logistic regression analysis revealed that age (odds ratio [OR], 1.007; P = 0.014), hypertension (OR, 0.821; P = 0.01), atrial fibrillation (OR, 1.180; P = 0.033), chronic kidney disease (OR, 1.697; P < 0.001), to know warfarin use reason (OR, 1.699; P < 0.001), and know to food-drug interaction with warfarin (OR, 1.583; P < 0.001) were independent predictors of adequate coagulation. Conclusion: Our study demonstrated that a low proportion of patients taking warfarin achieve an adequate TTR in daily practice. Furthermore, the patients with adequate TTR are more aware of warfarin use.http://www.ijcva.com/article.asp?issn=2405-8181;year=2018;volume=4;issue=4;spage=86;epage=89;aulast=KilicAdequate anticoagulationwarfarinwarfarin awareness
spellingShingle Salih Kilic
Ahmet Çelik
Ali Sabri Seyis
Ozge Kurmus
Kamil Tülüce
Zeynep Yapan Emren
Ali Kemal Kalkan
Mehdi Zoghi
Potential factors affecting the anticoagulation control in patients treated with warfarin: Results WARFARIN-TR study
International Journal of the Cardiovascular Academy
Adequate anticoagulation
warfarin
warfarin awareness
title Potential factors affecting the anticoagulation control in patients treated with warfarin: Results WARFARIN-TR study
title_full Potential factors affecting the anticoagulation control in patients treated with warfarin: Results WARFARIN-TR study
title_fullStr Potential factors affecting the anticoagulation control in patients treated with warfarin: Results WARFARIN-TR study
title_full_unstemmed Potential factors affecting the anticoagulation control in patients treated with warfarin: Results WARFARIN-TR study
title_short Potential factors affecting the anticoagulation control in patients treated with warfarin: Results WARFARIN-TR study
title_sort potential factors affecting the anticoagulation control in patients treated with warfarin results warfarin tr study
topic Adequate anticoagulation
warfarin
warfarin awareness
url http://www.ijcva.com/article.asp?issn=2405-8181;year=2018;volume=4;issue=4;spage=86;epage=89;aulast=Kilic
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