Determination of Plasma Warfarin Concentrations in Korean Patients and Its Potential for Clinical Application
| Autor: | Min-Jung Kwon, Soo-Youn Lee, Young-Keun On, Jong-Won Kim, Hyun-Jung Cho, Kyunghoon Lee, Hee Jin Kim, J. Kim, Kie-Ho Sohn |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Clinical Biochemistry Patient response Gastroenterology Pharmacotherapy Therapeutic index Asian People Tandem Mass Spectrometry Internal medicine Atrial Fibrillation Republic of Korea medicine Humans heterocyclic compounds cardiovascular diseases Chromatography High Pressure Liquid Aged Aged 80 and over Maintenance dose business.industry Biochemistry (medical) Warfarin Anticoagulants On warfarin Atrial fibrillation General Medicine Middle Aged medicine.disease Anesthesia Oral anticoagulant Female business medicine.drug |
| Zdroj: | Annals of Laboratory Medicine. 29:515-523 |
| ISSN: | 2234-3814 2234-3806 |
| DOI: | 10.3343/kjlm.2009.29.6.515 |
| Popis: | BACKGROUND Warfarin is a widely used oral anticoagulant with broad within- and between-individual dose requirements. Warfarin concentrations can be monitored by assessing its pharmacologic effects on International Normalized Ratio (INR). However, this approach has not been applied in the routine clinical management of patients receiving warfarin therapy. We performed a plasma warfarin assay using high-performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS) to determine if such an assay can be utilized in routine clinical practice. METHODS We included a total of 105 patients with atrial fibrillation, and who were receiving warfarin for more than 1 yr. The plasma concentrations of total warfarin and 7-hydroxywarfarin were determined by HPLC-MS/MS (Waters, UK). We assessed the association between warfarin dose, concentration, and INR as well as the effects of these factors on warfarin concentrations. RESULTS The mean maintenance dose of warfarin in 105 patients was 4.1 +/-1.3 mg/day (range, 1.7-8.0 mg/day) and their mean plasma warfarin concentration was 1.3+/-0.5 mg/L. We defined a concentration range of 0.6-2.6 mg/L (corresponding to the 2.5th to 97.5th percentile range of the Plasma warfarin levels in the 74 patients showing INR within target range) as the therapeutic range for warfarin. The correlation of warfarin dose with warfarin concentration (r(2)=0.259, P |
| Databáze: | OpenAIRE |
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