ArticlePharmacotherapy2018
Influence of Age on Warfarin Dose, Anticoagulation Control, and Risk of Hemorrhage.
Article in Pharmacotherapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis 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.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Chinese expert consensus on prevention, diagnosis, and management of venous thromboembolism in adult burn patients (2024).Military Medical Research · 2025Guideline
- Pharmacists' interventions improve health-related quality of life of rural older person on warfarin: a randomized controlled trial.Scientific reports · 2021Trial
- Fixed dose versus 3-day loading dose warfarin initiation in atrial fibrillation: effects on INR stabilization and time in the therapeutic range.International journal of clinical pharmacy · 2026Article
- Review
- A Prediction Model of Stable Warfarin Doses in Patients After Mechanical Heart Valve Replacement Based on a Machine Learning Algorithm.Reviews in cardiovascular medicine · 2025Article
- Management of Atrial Fibrillation in Elderly Patients: A Whole New Ballgame?Journal of clinical medicine · 2025Review
- Analysis of Postoperative Bleeding After Oral Surgery in Patients Receiving Anticoagulants: A Retrospective Study.Medicina (Kaunas, Lithuania) · 2025Article
- Direct Oral Anticoagulants Compared With Warfarin in Patients With Atrial Fibrillation and Valvular Heart Disease Without Mechanical Valves.Journal of the American Heart Association · 2025Article
- Clinical Predictors of Warfarin Response Among Patients with Atrial Fibrillation: Evidence from the Middle Eastern JoFib Study.Current vascular pharmacology · 2025Observational
- Pharmacodynamic Modeling of Warfarin Dosing Algorithm for Cardiovascular Patients in Indonesia: A Tailored Method to Anticoagulation Therapy.Drug design, development and therapy · 2025Article
- Unraveling complexity: morbidity factors in elderly kidney transplant recipients.Clinical kidney journal · 2024Article
- Renal Function and Clinical Outcomes Among Elderly Patients With Nonvalvular Atrial Fibrillation From ANAFIE.JACC. Asia · 2023Article
- Short-term antithrombotic strategies after left atrial appendage occlusion: a systematic review and network meta-analysis.Frontiers in pharmacology · 2023Review
- Pharmacogenomics implementation in cardiovascular disease in a highly diverse population: initial findings and lessons learned from a pilot study in United Arab Emirates.Human genomics · 2022Article
- Warfarin dosing strategies evolution and its progress in the era of precision medicine, a narrative review.International journal of clinical pharmacy · 2022Review
- Profiling of warfarin pharmacokinetics-associated genetic variants: Black Africans portray unique genetic markers important for an African specific warfarin pharmacogenetics-dosing algorithm.Journal of thrombosis and haemostasis : JTH · 2021Article
- Using Pharmacogenetics of Direct Oral Anticoagulants to Predict Changes in Their Pharmacokinetics and the Risk of Adverse Drug Reactions.Biomedicines · 2021Review
- Article
- Nonalcoholic fatty liver disease impacts the control of the international normalized ratio in patients with atrial fibrillation.Annals of translational medicine · 2020Article
- VKORC1 and Novel CYP2C9 Variation Predict Warfarin Response in Alaska Native and American Indian People.Clinical and translational science · 2019Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveWe assessed the influence of age on warfarin dose, percentage time in target range (PTTR), and risk of major hemorrhage.
designWarfarin users recruited into a large prospective inception cohort study were categorized into three age groups: young (younger than 50 yrs), middle aged (50-70 yrs), and elderly (older than 70 yrs). The influence of age on warfarin dose and PTTR was assessed using regression analysis; risk of major hemorrhage was assessed using proportional hazards analysis. Models were adjusted for demographic, clinical, and genetic factors.
settingTwo outpatient anticoagulation clinics.
participantsA total of 1498 anticoagulated patients. OUTCOMES: Warfarin dose (mg/day), PTTR, major hemorrhage.
resultsOf the 1498 patients, 22.8% were young, 44.1% were middle aged, and 33.1% were elderly. After accounting for clinical and genetic factors, compared with young warfarin users, warfarin dose requirements were 10.6% lower among the middle aged and an additional 10.6% lower for the elderly. Compared with young patients, middle-aged and elderly patients spent more time in target international normalized ratio (INR) range (p<0.0001), despite having fewer INR assessments (p<0.0001). Compared with young warfarin users, absolute risk of hemorrhage was marginally higher among the middle aged (p=0.08) and significantly higher among the elderly (p=0.016). Compared with young warfarin users, after adjustment, the relative risk of hemorrhage increased by 31% for each age category (p=0.026).
conclusionsIn a real-world setting, despite achieving better anticoagulation control, elderly patients had a higher risk of major hemorrhagic events. As the population ages and the candidacy for oral anticoagulation increases, strategies that mitigate the elevated risk of hemorrhage need to be identified.
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Registered trials
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.