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Stability and clinical determinants of long‐term warfarin therapy: a retrospective study
Author(s) -
Ferland Guylaine,
Desjardins Katherine,
Presse Nancy,
Pharand Chantal
Publication year - 2010
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.24.1_supplement.533.4
Subject(s) - medicine , warfarin , medical record , retrospective cohort study , major bleeding , pediatrics , emergency medicine , intensive care medicine , atrial fibrillation
Anticoagulation (AC) with vitamin K antagonists (VKAs), notably warfarin, is the therapy of choice for the prevention and treatment of thrombotic complications. However, stability of treatment with VKAs remains a daily challenge with bleeding a common side effect of the treatment. To this day, causal factors for bleeding episodes remain ill defined. Here we present a study that aimed to characterize the stability and complications of patients undergoing AC therapy, and identify associated risk factors. The study included 1003 patients treated at the AC clinic of a Montreal university hospital between April 1 2008 and March 31 2009. Socio‐demographic and medical information were extracted from medical charts. Stability of anticoagulation was based on the International Normalized Ratio (INR). Half of patients spent 85% of the time within their respective therapeutic range and factors investigated explained only ~ 8 % of the treatment variance, with intensity of treatment, patient's health condition and non‐compliance to treatment contributing the most. Nutritional information was largely missing from the medical charts and could not be assessed as part of this study. Complications were few and minor in nature. This study highlights the lack of attention paid to nutritional factors, notably those related to vitamin K status, which could contribute to the unexplained treatment variance. Supported by CIHR.