Time to therapeutic range (TtTR), anticoagulation control, and cardiovascular events in vitamin K antagonists–naive patients with atrial fibrillation
| Autor: | Francesca Violi, Francesco Cribari, Pasquale Pignatelli, Mirella Saliola, Daniele Pastori, Gregory Y.H. Lip, Roberto Carnevale |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Percentile Hemorrhage Kaplan-Meier Estimate 030204 cardiovascular system & hematology Chemoprevention Risk Assessment 03 medical and health sciences 0302 clinical medicine Therapeutic index Interquartile range Risk Factors Internal medicine Thromboembolism Atrial Fibrillation medicine Humans Sinus rhythm 030212 general & internal medicine International Normalized Ratio Blood Coagulation Aged Aged 80 and over Anticoagulants Drug Monitoring Female Acenocoumarol Warfarin Proportional hazards model business.industry Hazard ratio Atrial fibrillation Odds ratio medicine.disease Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Pastori, D, Pignatelli, P, Cribari, F, Carnevale, R, Saliola, M, Violi, F & Lip, G Y H 2018, ' Time to therapeutic range (TtTR), anticoagulation control, and cardiovascular events in vitamin K antagonists–naive patients with atrial fibrillation ', American Heart Journal, vol. 200, pp. 32-36 . https://doi.org/10.1016/j.ahj.2018.03.004 |
| DOI: | 10.1016/j.ahj.2018.03.004 |
| Popis: | Background: Vitamin K antagonists (VKAs) reduce cardiovascular events (CVEs) in atrial fibrillation (AF) when a time in therapeutic range (TiTR) >70% is achieved. Factors affecting the time to achieve the TR (TtTR) are unknown. Methods: Prospective observational study including 1,406 nonvalvular AF patients starting VKAs followed for a mean of 31.3 months (3,690 patient/year); TiTR, TtTR, and SAMe-TT 2R 2 score were calculated, and CVEs were recorded. Results: Median TtTR was 8.0 days (interquartile range 5.0-18.0). Patients with high TtTR (ie, >75th percentile) were more likely to be in AF than in sinus rhythm at entry (odds ratio [OR]: 1.423, P =.011). Median TiTR was 60.0%; low TiTR (below median) was associated with SAMe-TT 2R 2 score (OR: 1.175, P =.001), high TtTR (>75th percentile, OR: 1.357, P =.017), and number of international normalized ratio checks (OR: 0.998, P =.049). We recorded 113 CVEs (3.1%/y), with a higher rate seen in patients with TtTR >75th percentile compared to those below (log-rank test, P =.006). A multivariable Cox regression analysis showed that SAMe-TT 2R 2 score (hazard ratio [HR]: 1.331, P 75th percentile (HR: 1.505, P =.047), TiTR 18 days or with high SAMe-TT 2R 2 score should be considered for treatment with non–vitamin K oral anticoagulants. |
| Databáze: | OpenAIRE |
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