Long-term follow-up study of warfarin anticoagulant therapy effect of different intensity on patients with nonvalvular atrial fibrillation
10.3969/j.issn.1008-0074.2016.02.12
- VernacularTitle:不同强度华法林抗凝治疗非瓣膜病性房颤患者疗效长期随访研究
- Author:
Yuntao WU
;
Yingchun GAO
;
Guoxiang TIAN
;
Changquan XIA
;
Lu YAO
;
Wei ZHANG
;
Runxiu ZHU
- Publication Type:Journal Article
- Keywords:
Atrial fibrillation;
International normalized ratio;
Safety;
Warfarin
- From:
Chinese Journal of cardiovascular Rehabilitation Medicine
2016;25(2):153-157
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze long-term therapeutic effect and safety of warfarin anticoagulant therapy of differ- ent intensity on aged patients with nonvalvular atrial fibrillation (NVAF). Methods:According to age,a total of 197 NVAF patients followed up for five years were divided into advanced aged group [n=65,≥80 (85.00±2.09) years],aged group [n=75,65-79 (76.50±2.27)years]and middle-aged group [n=57,<65 (57.40±2.18) years].All enrolled patients received long-term warfarin anticoagulant therapy,advanced aged group and aged group received low intensity anticoagulation,international normalized ratio (INR)was 1.6~2.5,while middle-aged group received standard intensity anticoagulation and the INR was 2.0~3.0. Thrombus events and incidence rates of hemorrhage etc.over five years were compared among three groups,and the safe dose range of warfarin was ex- plored.Results:During five-year follow-up,no acute cerebral infarction occurred in three groups.The bleeding and other adverse reaction among three groups were no significant difference (P>0.05).Compared with middle- aged group,there were significant reductions in warfarin dose [(3.29±0.49)mg/d vs.(2.95±0.38)mg/d,(2.85 ±0.49)mg/d],INR [(2.54±0.43)vs.(2.20±0.29),(2.16±0.32)]and CHA2DS2-VASc [(3.02±0.89) scores vs.(2.64±0.77)scores vs.(2.33±0.48)scores]in aged group and advanced aged group,P<0.01 all;but there were no significant difference between aged group and advanced aged group (P>0.05).There were no signif- icant difference in incidence rates of mild hemorrhage (21.1% vs.14.7% vs.24.6%)and severe hemorrhage (1.8% vs.1.3% vs.1.5%)among middle-aged group,aged group and advanced aged group,P>0.05 all.Conclu-sion:When INR is closely monitored,INR controlled within 1.6-2.5 warfarin anticoagulation is safe and effective for in aged patients with nonvalvular atrial fibrillation.
