Sökning: (WFRF:(Gasparini Alessandro)) srt2:(2017) >
Time in therapeutic...
Time in therapeutic range and outcomes after warfarin initiation in newly diagnosed atrial fibrillation patients with renal dysfunction
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- Szummer, Karolina (författare)
- Karolinska Institutet,Karolinska Univ Hosp, Karolinska Inst, Dept Med, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Cardiol, Stockholm, Sweden.
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- Gasparini, Alessandro (författare)
- Karolinska Institutet,Danderyd Hosp, Renal Med, Dept Clin Sci, Stockholm, Sweden.;Danderyd Hosp, Renal Med, Dept Technol & Intervent CLINTEC, Stockholm, Sweden.
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- Eliasson, Staffan (författare)
- Karolinska Univ Hosp, Dept Nephrol, Stockholm, Sweden.
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- Ärnlöv, Johan (författare)
- Uppsala universitet,Karolinska Institutet,Högskolan Dalarna,Medicinsk vetenskap,Uppsala university,Institutionen för medicinska vetenskaper,Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden.
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- Qureshi, Abdul Rashid (författare)
- Karolinska Institutet,Danderyd Hosp, Renal Med, Dept Clin Sci, Stockholm, Sweden.;Danderyd Hosp, Renal Med, Dept Technol & Intervent CLINTEC, Stockholm, Sweden.
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- Bárány, Peter (författare)
- Karolinska Institutet,Danderyd Hosp, Renal Med, Dept Clin Sci, Stockholm, Sweden.;Danderyd Hosp, Renal Med, Dept Technol & Intervent CLINTEC, Stockholm, Sweden.
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- Evans, Marie (författare)
- Karolinska Institutet,Danderyd Hosp, Renal Med, Dept Clin Sci, Stockholm, Sweden.;Danderyd Hosp, Renal Med, Dept Technol & Intervent CLINTEC, Stockholm, Sweden.
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- Friberg, Leif (författare)
- Karolinska Institutet,Danderyd Hosp, Dept Clin Sci, Stockholm, Sweden.
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- Carrero, Juan Jesus (författare)
- Karolinska Institutet,Danderyd Hosp, Renal Med, Dept Clin Sci, Stockholm, Sweden.;Danderyd Hosp, Renal Med, Dept Technol & Intervent CLINTEC, Stockholm, Sweden.;Karolinska Inst, Ctr Mol Med, Stockholm, Sweden.
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Karolinska Institutet Karolinska Univ Hosp, Karolinska Inst, Dept Med, Stockholm, Sweden;Karolinska Univ Hosp, Dept Cardiol, Stockholm, Sweden. (creator_code:org_t)
- WILEY, 2017
- 2017
- Engelska.
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Ingår i: Journal of the American Heart Association. - : WILEY. - 2047-9980. ; 6:3
- Relaterad länk:
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https://doi.org/10.1...
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https://du.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- 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
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- all‐cause death
- anticoagulant
- atrial fibrillation
- bleeding
- ischemic stroke
- renal function
- Hälsa och välfärd
- Health and Welfare
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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