What is the clinical evidence from this study?

Study design: Observational. Population: Non-valvular atrial fibrillation (n=501). Intervention: Warfarin therapy. Primary outcome: Time in the therapeutic range (TTR).

January 1, 2011Circulation JournalOpen Access

Time in the Therapeutic Range During Warfarin Therapy in Japanese Patients With Non-Valvular Atrial Fibrillation - A Multicenter Study of Its Status and Influential Factors -

Q: What are the key findings of this study?

In Japanese patients with non-valvular atrial fibrillation, the overall time in the therapeutic range during warfarin therapy was 64%, and was significantly lower in patients under 70 years compared to those 70 or older (46% vs 77%, p<0.0001).

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This research aims to evaluate the time in the therapeutic range (TTR) during warfarin therapy in Japanese patients with non-valvular atrial fibrillation and identify influencing factors.
Enrolled 501 patients with atrial fibrillation taking warfarin for ≥ 2 years across 5 prefectures.
Measured TTR based on PT-INR, with age, gender, CHADS₂ score, and warfarin doses assessed as potential influencing factors.
Conducted multivariate analysis to identify independent predictors of TTR.
TTR was 64 ± 25% overall, with institutional variations (56% to 74%).
TTR for patients < 70 years was 46 ± 23%, while for patients ≥ 70 years, it was 77 ± 17% (P < 0.0001).
Lower warfarin doses correlated with higher TTR: 72 ± 22% (< 2.0 mg), 63 ± 25% (2.0-4.9 mg), and 48 ± 24% (≥ 5.0 mg) with all P < 0.001.

Study Design

Type

Observational (n=501)

Multicenter

Yes

Structured PICO

Population

501 Japanese patients with non-valvular atrial fibrillation taking warfarin for at least 2 years, followed for a mean of 1.9 years to assess time in therapeutic range.

Exposure

Warfarin therapy adjusted according to Japanese Guidelines (PT-INR 2.0-3.0 for <70 years, 1.6-2.6 for ≥70 years)

Outcome

Time in the therapeutic range (TTR) of PT-INR calculated over a 2-year periodsurrogate

Limitations

Retrospective analysis of patient records
Excluded patients with stroke, systemic thromboembolism, or major hemorrhage during the study period
The age-specific protocol of PT-INR control (different target ranges for patients <70 vs ≥70 years) might have affected TTR primarily rather than age itself
Retrospective analysis
Did not include patients with stroke, systemic thromboembolism, or major hemorrhage during the study period
Age-specific protocol of PT-INR control might have affected TTR primarily rather than age itself

Discussion

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Implication

Suboptimal TTR in younger Japanese AF patients cautions against warfarin reliance; extends age-specific anticoagulation quality data.

Cite This Study

Okumura et al. (2011) conducted an observational in Non-valvular atrial fibrillation (n=501). Warfarin therapy was evaluated on Time in the therapeutic range (TTR). In Japanese patients with non-valvular atrial fibrillation, the overall time in the therapeutic range during warfarin therapy was 64%, and was significantly lower in patients under 70 years compared to those 70 or older (46% vs 77%, p<0.0001).

synapsesocial.com/papers/6a20ae09920e38fa09f9e6a6 https://doi.org/10.1253/circj.cj-11-0350

Topics

Atrial fibrillation Anticoagulation in AF Persistent AF management

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Time in the Therapeutic Range During Warfarin Therapy in Japanese Patients With Non-Valvular Atrial Fibrillation - A Multicenter Study of Its Status and Influential Factors -

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Time in the Therapeutic Range During Warfarin Therapy in Japanese Patients With Non-Valvular Atrial Fibrillation - A Multicenter Study of Its Status and Influential Factors -

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

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Topics

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