Postdischarge International Normalized Ratio Testing and Long-term Clinical Outcomes of Patients With Heart Failure Receiving Warfarin: Findings From the ADHERE Registry Linked to Medicare Claims
| Autor: | Roger M. Mills, Winslow Klaskala, Adrian F. Hernandez, Laura G. Qualls, Zubin J. Eapen, Gregg C. Fonarow, Lesley H. Curtis, Melissa A. Greiner |
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| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Acute decompensated heart failure business.industry Proportional hazards model Hazard ratio valvular heart disease Warfarin Atrial fibrillation Retrospective cohort study General Medicine medicine.disease Internal medicine Heart failure Cardiology Medicine cardiovascular diseases Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Clinical Cardiology. 36:757-765 |
| ISSN: | 0160-9289 |
| Popis: | Background Effective warfarin thromboprophylaxis requires maintaining anticoagulation within the recommended international normalized ratio (INR) range. INR testing rates and associations between testing and outcomes are not well understood. Hypothesis INR testing rates after hospitalization for acute decompensated heart failure are suboptimal, and testing is associated with lower risks of mortality and adverse clinical events. Methods We conducted a retrospective cohort study of patients who were long-term warfarin users and were hospitalized for heart failure, had a medical history of atrial fibrillation or valvular heart disease, and were enrolled in fee-for-service Medicare. INR testing was defined as ≥1 outpatient INR test within 45 days after discharge. Using Cox proportional hazards models, we examined associations between testing and all-cause mortality, all-cause readmission, and adverse clinical events at 1 year. Results Among 8558 patients, 7722 (90.2%) were tested. After 1 year, tested patients had lower all-cause mortality (23.5% vs 32.6%; P |
| Databáze: | OpenAIRE |
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