Sökning: WFRF:(Carrero Juan Jesus) >
Time in therapeutic...
-
Szummer, Karolina
(författare)
Time in therapeutic range and outcomes after warfarin initiation in newly diagnosed atrial fibrillation patients with renal dysfunction
- E-artikel/E-kapitelEngelska2017
Förlag, utgivningsår, omfång ...
Nummerbeteckningar
-
LIBRIS-ID:20142866
-
http://urn.kb.se/resolve?urn=urn:nbn:se:du-24516uri
-
urn:nbn:se:du-24516urn
-
10.1161/JAHA.116.004925doi
Kompletterande språkuppgifter
Ingår i deldatabas
Anmärkningar
-
Published
-
gratis
-
BACKGROUND: It is unknown whether renal dysfunction conveys poor anticoagulation control in warfarin-treated patients with atrial fibrillation and whether poor anticoagulation control associates with the risk of adverse outcomes in these patients. METHODS AND RESULTS: This was an observational study from the Stockholm CREatinine Measurements (SCREAM) cohort including all newly diagnosed atrial fibrillation patients initiating treatment with warfarin (n=7738) in Stockholm, Sweden, between 2006 and 2011. Estimated glomerular filtration rate (eGFR; mL/min per 1.73 m(2)) was calculated from serum creatinine. Time-in-therapeutic range (TTR) was assessed from international normalized ratio (INR) measurements up to warfarin cessation, adverse event, or end of follow-up (2 years). Adverse events considered a composite of intracranial hemorrhage, ischemic stroke, myocardial infarction, or death. During median 254 days, TTR was 83%, based on median 21 INR measurements per patient. TTR was 70% among patients with eGFR <30, around 10% lower than in those with normal renal function. During observation, adverse events occurred in 4.0% of patients, and those with TTR ≤75% were at higher adverse event risk. This was independent of patient characteristics, comorbidities, number of INR tests, days exposed to warfarin, and, notably, independent of eGFR: adjusted odds ratio (OR) 1.84 (95% CI, 1.41-2.40) for TTR 75% to 60% and adjusted OR 2.09 (1.59-2.74) for TTR <60%. No interaction was observed between eGFR and TTR in association to adverse events (P=0.2). CONCLUSION: Severe chronic kidney disease (eGFR <30) patients with atrial fibrillation have worse INR control while on warfarin. An optimal TTR (>75%) is associated with lower risk of adverse events, independently of underlying renal function.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
-
Gasparini, Alessandro
(författare)
-
Eliasson, Staffan
(författare)
-
Ärnlöv, Johan
(författare)
-
Qureshi, Abdul Rashid
(författare)
-
Bárány, Peter
(författare)
-
Evans, Marie
(författare)
-
Friberg, Leif
(författare)
-
Carrero, Juan Jesus
(författare)
-
Högskolan DalarnaAkademin Utbildning, hälsa och samhälle
(utgivare)
Sammanhörande titlar
-
Del av/supplement till:channel record
-
Ingår i:VärdpublikationJournal of the American Heart Association6:32047-9980
Internetlänk
Hitta via bibliotek
Till lärosätets databas