Original articles

Warfarin anticoagulation in elderly patients with atrial fibrillation : evaluation by occurrence of adverse cardiovascular events

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  • a. Department of Cardiology; b. Department of Laboratory, Shanghai Shidong Hospital, Yangpu District, Shanghai 200438, China

Received date: 2016-07-29

  Online published: 2022-07-27

Abstract

Objective: To investigate the occurrence of adverse cardiovascular events in elderly patients with atrial fibrillation (AF) during anticoagulation with warfarin. Methods: One hundred and eight older patients (80 years or older) taking warfarin for AF were enrolled. According to the value of international normalized ratio (INR), patients were divided into 2 groups, low intensity warfarin group (INR between 1.40 and 1.80, n=52) and moderate intensity warfarin group (INR between 1.81 and 2.50, n=56), and effects and safety were compared. All patients were followed up for (1.8±1.2) years. The major end point events included the occurrence of ischemic stroke or systemic embolism;the secondary endpoint events included non-fatal myocardial infarction and all causes of death. The safety endpoint events included the occurrence of the mild, severe and fatal hemorrhage. Results: Embolism occurred in 3 patients (5.36%) in moderate intensity warfarin group and in 6 patients (11.54%) in low intensity warfarin group (all were cerebral stroke); the difference was statistically significant. Conjunctival and nasal hemorrhage occurred in 2 patients in low intensity warfarin group and in 3 patients in moderate intensity warfarin group; no severe hemorrhage was seen in all the patients. No significant difference in hemorrhagic rate was seen between the low intensity and moderate intensity warfarin groups (P>0.05). Conclusions: The INR ranged from 1.81-2.50 is safe for elderly patients with atrial fibrillation treated with warfarin for anticoagulation.

Cite this article

HUANG Hongman, ZHA Shuangying, LIU Xinbing, BO Xiaosong, FENG Liuliu . Warfarin anticoagulation in elderly patients with atrial fibrillation : evaluation by occurrence of adverse cardiovascular events[J]. Journal of Diagnostics Concepts & Practice, 2016 , 15(05) : 513 -516 . DOI: 10.16150/j.1671-2870.2016.05.016

References

[1] Torn M, Bollen WL, van der Meer FJ, et al. Risks of oral anticoagulant therapy with increasing age[J]. Arch Intern Med,2005,165(13):1527-1532.
[2] Fang MC, Chang Y, Hylek EM, et al.Advanced age, anticoagulation intensity, and risk for intracranial hemorrhage among patients taking warfarin for atrial fibrillation[J]. Ann Intern Med,2004,141(10):745-752.
[3] Levine MN, Raskob G, Beyth RJ, et al.Hemorrhagic complications of anticoagulant treatment: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy[J]. Chest,2004,126(3 Suppl):287S-310S.
[4] 《中华医学会心血管病学分会中华心血管病杂志》编辑委员会. 抗心律失常药物治疗建议[J]. 中华心血管病杂志,2009,29(6):323-336.
[5] 孙艺红, 胡大一. 华法林对中国人心房颤动患者抗栓的安全性和有效性研究[J]. 中华内科杂志2004,43(4):258-260.
[6] 陈松文, 刘少稳. 心房颤动患者应用新型口服抗凝药物的指南解读[J]. 诊断学理论与实践,2015,14(3):204-207.
[7] 曹雪滨, 王玉雯, 黄河玲, 等. 93例老年心房颤动患者栓塞事件的临床病理分析[J]. 中华老年医学杂志,2000,19(3):225-226.
[8] Fuster V, Rydén LE, Cannom DS, et al.ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardio-logy Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society[J]. Circulation,2006,114(7):e257-e354.
[9] Wann LS, Curtis AB, January CT, et al.2011 ACCF/AHA/HRS focused update on the management of patients with atrial fibrillation (updating the 2006 guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[J]. Circulation,2011,123(1):104-123.
[10] January CT, Wann LS, Alpert JS, et al.2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm So-ciety[J]. Circulation,2014,130(23):2071-2104.
[11] Suzuki S, Yamashita T, Kato T, et al.Incidence of major bleeding complication of warfarin therapy in Japanese patients with atrial fibrillation[J]. Circ J,2007,71(5):761-765.
[12] 孙雪峰, 周希静, 王力宁. 华法林抗凝疗法对糖尿病肾病的疗效[J]. 中华内分泌代谢杂志,2002,18(4):269-270.
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