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187136

Real –life International Normalized Ratio (INR) profile ; Egyptian study

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Last updated: 28 Dec 2024

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Abstract

Warfarin remains widely used by patients with cardiovascular diseases[.Due to high interindividual variability, the anticoagulant activity of warfarin has to be monitored using the international normalized ratio (INR).The most widely recommended approach for evaluating the quality and safety of anticoagulation is to estimate the percentage of time in therapeutic range (TTR). It was a single center, cross-sectional observational study that was conducted at cardiology department at Benha University Hospital. This study was designed to: Study the INR values in patients on VKAs in the selected area., Calculation of the time in the therapeutic range (TTR) when is possible according to the number of INR/Patient., Find out which patient characteristics that are associated with good INR control. Patients were subdivided into two sub groups; sub group I : patients with TTR ≥ 65% , sub group II : patients with TTR < 65% .The study was designed to screen not less than 2000 INR laboratory tests from these patients. Mean TTR was 60.27%+_24.48% for the Rosendaal method. After multivariate adjustment,variables associated with good anticoagulation control were university studies (OR: 1.99, 95% CI: 1.08-3.64), chronic hepatic disease (OR: 8.15, 95% CI: 1.57-42.24), low comorbidity expressed as Charlson index(OR: 0.87, 95% CI: 0.76-0.99) , no previous cardiac disease (OR: 0.64, 95% CI: 0.41-0.98), lower risk of bleeding assessed as hypertension, abnormal enal/liver function, stroke, bleeding history or predisposition, rlabile international normalized ratio, elderly age, and use of drugs or alcohol { HAS-BLED} (OR: 0.81, 95% CI: 0.69-0.95), and lower heart rate OR: 0.99, 95% CI: 0.98-0.99). Our study shows a rate of inadequate control with AVKs of 54%, and 46% of the patients spent more than half the time outside the therapeutic range. .In our study, having a university degree was associated with adequate anticoagulation control.We believe that higher education helps patients to understand the importance of anticoagulant treatment adherence.

DOI

10.21608/bjas.2019.187136

Keywords

Warfarin, international normalized ratio (INR), Time in therapeutic range (TTR), Education and control

Authors

First Name

O.

Last Name

Arafa

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Affiliation

Cardiology Dept., Faculty of medicine, Benha Univ., Benha, Egypt

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Orcid

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First Name

A.

Last Name

Hassan

MiddleName

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Affiliation

Cardiology Dept., Faculty of medicine, Benha Univ., Benha, Egypt

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First Name

S.

Last Name

Ebrahim

MiddleName

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Affiliation

Cardiology Dept., Faculty of medicine, Benha Univ., Benha, Egypt

Email

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Orcid

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First Name

.Abd-

Last Name

El-Aziz

MiddleName

-

Affiliation

Cardiology Dept., Faculty of medicine, Benha Univ., Benha, Egypt

Email

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City

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Orcid

-

First Name

H

Last Name

.Mohamed

MiddleName

-

Affiliation

Cardiology Dept., Faculty of medicine, Benha Univ., Benha, Egypt

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Volume

4

Article Issue

1

Related Issue

23361

Issue Date

2019-03-01

Receive Date

2019-08-03

Publish Date

2019-03-01

Page Start

147

Page End

151

Print ISSN

2356-9751

Online ISSN

2356-976X

Link

https://bjas.journals.ekb.eg/article_187136.html

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https://bjas.journals.ekb.eg/service?article_code=187136

Order

25

Type

Original Research Papers

Type Code

1,647

Publication Type

Journal

Publication Title

Benha Journal of Applied Sciences

Publication Link

https://bjas.journals.ekb.eg/

MainTitle

Real –life International Normalized Ratio (INR) profile ; Egyptian study

Details

Type

Article

Created At

23 Jan 2023