ArticleInternational journal of clinical pharmacy2015
INR optimization based on stroke risk factors in patients with non-valvular atrial fibrillation.
Article in International journal of clinical pharmacy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed, 4 citations in OpenAlex.
- Efficacy and safety of different intensities of anticoagulation with warfarin in elderly patients with non-valvular atrial fibrillation.Pakistan journal of medical sciences · 2026Article
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Authors and funding
5 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundBleeding complications have been frequently reported in East Asian patients on warfarin with a target international normalized ratio (INR) of 2.0-3.0.
objectiveThis study aimed to identify the optimal therapeutic range of the INR in Korean patients with non-valvular atrial fibrillation (NVAF). Setting Cardiovascular department of a 1320 inpatient bed Korean hospital.
methodRetrospective chart review was conducted on 1014 patients for a total follow-up period of 2249.2 patient years. Major thromboembolic and bleeding complications were evaluated. The INR incidence of complication curve was plotted, and the optimal therapeutic range of INR was determined from the intersection of curves to ensure the lowest incidences of both thromboembolic and bleeding complications. For subgroup analysis, all patients were stratified by the following factors: age (above 75), disease (presence of hypertension, diabetes, congestive heart failure, and a history of stroke or thromboembolism), rhythm control procedure, and concurrent aspirin therapy. Main outcome measure Optimal therapeutic ranges of INR according to the risk factors.
resultsA total of 41 thromboembolic and 91 bleeding events occurred during the follow-up period. The complication rates were the lowest at an INR of 1.9 and the optimal therapeutic range was estimated to be 1.7-2.2 for the overall patients. The optimal therapeutic ranges of INR in the stratified patients were determined as follows: 1.3-1.8 in the patients ≥75 years of age; 1.5-2.0 in patients with hypertension, diabetes and concurrent aspirin therapy; 1.8-2.3 in patients with congestive heart failure; 1.9-2.4 in patients with previous stroke or thromboembolism; 1.7-2.2 in patients who had undergone rhythm control procedures. It has been shown that, by keeping the INR within these ranges, complication risks could be significantly reduced by up to 81 %.
conclusionThe intensity of anticoagulation therapy for Korean patients with NVAF is optimal when INR is between 1.7 and 2.2.
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