ArticleHeart (British Cardiac Society)2005
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.
Article in Heart (British Cardiac Society), 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 98 papers, 6 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
98 citing papers in PubMed, 6 syntheses or guidelines pooled it, 340 citations in OpenAlex.
- Efficacy of rivaroxaban for pulmonary embolism.Medicine · 2019Pooled it
- Measures of vitamin K antagonist control reported in atrial fibrillation and venous thromboembolism studies: a systematic review.BMJ open · 2014Pooled it
- Direct thrombin inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in people with non-valvular atrial fibrillation.The Cochrane database of systematic reviews · 2014Pooled it
- Comparisons between novel oral anticoagulants and vitamin K antagonists in patients with CKD.Journal of the American Society of Nephrology : JASN · 2014Pooled it
- Guideline
- Computerized clinical decision support systems for therapeutic drug monitoring and dosing: a decision-maker-researcher partnership systematic review.Implementation science : IS · 2011Pooled it
- The Effect of Warfarin Administration Time on Anticoagulation Stability (INRange): A Pragmatic Randomized Controlled Trial.Annals of family medicine · 2020Trial
- Dabigatran vs. warfarin in relation to the presence of left ventricular hypertrophy in patients with atrial fibrillation- the Randomized Evaluation of Long-term anticoagulation therapY (RE-LY) study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2018Trial
- Polypharmacy and effects of apixaban versus warfarin in patients with atrial fibrillation: post hoc analysis of the ARISTOTLE trial.BMJ (Clinical research ed.) · 2016Trial
- Pharmacoepidemiologic study of warfarin prescription in a Brazilian tertiary hospital.Journal of thrombosis and thrombolysis · 2014Trial
- Population pharmacokinetics and pharmacodynamics of rivaroxaban in patients with acute coronary syndromes.British journal of clinical pharmacology · 2012Trial
- TRial of an Educational intervention on patients' knowledge of Atrial fibrillation and anticoagulant therapy, INR control, and outcome of Treatment with warfarin (TREAT).BMC cardiovascular disorders · 2010Trial
- A re-appraisal of warfarin control in the treatment of deep vein thrombosis and / or pulmonary embolism.African health sciences · 2009Trial
- Nontherapeutic INR After Hospital Discharge: A Repeated-Measures Analysis of Warfarin-Treated Patients and Potential Drug-Drug Interactions.Clinics and practice · 2026Article
- SAMe-TTJACC. Asia · 2025Article
- Incidence and Predictors of Clinical Outcomes in Patients with Valvular and Nonvalvular Atrial Fibrillation Using Vitamin K Antagonists.Arquivos brasileiros de cardiologia · 2025Article
- Genetic diversity of variants involved in drug response among Tunisian and Italian populations toward personalized medicine.Scientific reports · 2024Article
- Being precise with anticoagulation to reduce adverse drug reactions: are we there yet?The pharmacogenomics journal · 2024Review
- Optimizing warfarin dosing for patients with atrial fibrillation using machine learning.Scientific reports · 2024Article
- Cardiovascular precision medicine - A pharmacogenomic perspective.Cambridge prisms. Precision medicine · 2023Review
38 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate how well patients with non-valvar atrial fibrillation (NVAF) were maintained within the recommended international normalised ratio (INR) target of 2.0-3.0 and to explore the relation between achieved INR control and clinical outcomes.
designRecord linkage study of routine activity records and INR measurements.
settingCardiff and the Vale of Glamorgan, South Wales, UK.
participants2223 patients with NVAF, no history of heart valve replacement, and with at least five INR measurements.
main outcome measuresMortality, ischaemic stroke, all thromboembolic events, bleeding events, hospitalisation, and patterns of INR monitoring.
resultsPatients treated with warfarin were outside the INR target range 32.1% of the time, with 15.4% INR values > 3.0 and 16.7% INR values < 2.0. However, the quartile with worst control spent 71.6% of their time out of target range compared with only 16.3% out of range in the best controlled quartile. The median period between INR tests was 16 days. Time spent outside the target range decreased as the duration of INR monitoring increased, from 52% in the first three months of monitoring to 30% after two years. A multivariate logistic regression model showed that a 10% increase in time out of range was associated with an increased risk of mortality (odds ratio (OR) 1.29, p < 0.001) and of an ischaemic stroke (OR 1.10, p = 0.006) and other thromboembolic events (OR 1.12, p < 0.001). The rate of hospitalisation was higher when INR was outside the target range.
conclusionsSuboptimal anticoagulation was associated with poor clinical outcomes, even in a well controlled population. However, good control was difficult to achieve and maintain. New measures are needed to improve maintenance anticoagulation in patients with NVAF.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.