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Article: Comparison of outcomes among patients randomized to warfarin therapy according to anticoagulant control results from SPORTIF III and V

TitleComparison of outcomes among patients randomized to warfarin therapy according to anticoagulant control results from SPORTIF III and V
Authors
Issue Date2007
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archinternmed.com
Citation
Archives Of Internal Medicine, 2007, v. 167 n. 3, p. 239-245 How to Cite?
AbstractBackground: Warfarin sodium reduces stroke risk in patients with atrial fibrillation, but international normalized ratio (INR) monitoring is required. Target INRs are frequently not achieved, and the risk of death, bleeding, myocardial infarction (MI), and stroke or systemic embolism event (SEE) may be related to INR control. Methods: We analyzed the relationship between INR control and the rates of death, bleeding, MI, and stroke or SEE among 3587 patients with atrial fibrillation randomized to receive warfarin treatment in the SPORTIF (Stroke Prevention Using an Oral Thrombin Inhibitor in Atrial Fibrillation) III and V trials. The mean±SD follow-up was 16.6±6.3 months. Patients were divided into 3 equal groups (those with good control [>75%], those with moderate control [60%-75%], or those with poor control [<60%]) according to the percentage time with an INR of 2.0 to 3.0. Outcomes were compared according to INR control. The main outcome measures were death, bleeding, MI, and stroke or SEE. Results: The poor control group had higher rates of annual mortality (4.20%) and major bleeding (3.85%) compared with the moderate control group (1.84% and 1.96%, respectively) and the good control group (1.69% and 1.58%, respectively) (P<.01 for all). Compared with the good control group, the poor control group had higher rates of MI (1.38% vs 0.62%, P=.04) and of stroke or SEE (2.10% vs 1.07%, P=.02). Conclusions: In patients with atrial fibrillation taking warfarin, the risks of death, MI, major bleeding, and stroke or SEE are related to INR control. Good INR control is important to improve patient outcomes. ©2007 American Medical Association. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/163063
ISSN
2014 Impact Factor: 17.333
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWhite, HDen_US
dc.contributor.authorGruber, Men_US
dc.contributor.authorFeyzi, Jen_US
dc.contributor.authorKaatz, Sen_US
dc.contributor.authorTse, HFen_US
dc.contributor.authorHusted, Sen_US
dc.contributor.authorAlbers, GWen_US
dc.date.accessioned2012-09-05T05:27:07Z-
dc.date.available2012-09-05T05:27:07Z-
dc.date.issued2007en_US
dc.identifier.citationArchives Of Internal Medicine, 2007, v. 167 n. 3, p. 239-245en_US
dc.identifier.issn0003-9926en_US
dc.identifier.urihttp://hdl.handle.net/10722/163063-
dc.description.abstractBackground: Warfarin sodium reduces stroke risk in patients with atrial fibrillation, but international normalized ratio (INR) monitoring is required. Target INRs are frequently not achieved, and the risk of death, bleeding, myocardial infarction (MI), and stroke or systemic embolism event (SEE) may be related to INR control. Methods: We analyzed the relationship between INR control and the rates of death, bleeding, MI, and stroke or SEE among 3587 patients with atrial fibrillation randomized to receive warfarin treatment in the SPORTIF (Stroke Prevention Using an Oral Thrombin Inhibitor in Atrial Fibrillation) III and V trials. The mean±SD follow-up was 16.6±6.3 months. Patients were divided into 3 equal groups (those with good control [>75%], those with moderate control [60%-75%], or those with poor control [<60%]) according to the percentage time with an INR of 2.0 to 3.0. Outcomes were compared according to INR control. The main outcome measures were death, bleeding, MI, and stroke or SEE. Results: The poor control group had higher rates of annual mortality (4.20%) and major bleeding (3.85%) compared with the moderate control group (1.84% and 1.96%, respectively) and the good control group (1.69% and 1.58%, respectively) (P<.01 for all). Compared with the good control group, the poor control group had higher rates of MI (1.38% vs 0.62%, P=.04) and of stroke or SEE (2.10% vs 1.07%, P=.02). Conclusions: In patients with atrial fibrillation taking warfarin, the risks of death, MI, major bleeding, and stroke or SEE are related to INR control. Good INR control is important to improve patient outcomes. ©2007 American Medical Association. All rights reserved.en_US
dc.languageengen_US
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archinternmed.comen_US
dc.relation.ispartofArchives of Internal Medicineen_US
dc.subject.meshAgeden_US
dc.subject.meshAnticoagulants - Administration & Dosageen_US
dc.subject.meshAtrial Fibrillation - Drug Therapy - Mortalityen_US
dc.subject.meshEmbolism - Epidemiologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHemorrhage - Epidemiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshInternational Normalized Ratioen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMyocardial Infarction - Epidemiologyen_US
dc.subject.meshStroke - Epidemiologyen_US
dc.subject.meshSurvival Rateen_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshWarfarin - Administration & Dosageen_US
dc.titleComparison of outcomes among patients randomized to warfarin therapy according to anticoagulant control results from SPORTIF III and Ven_US
dc.typeArticleen_US
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1001/archinte.167.3.239en_US
dc.identifier.pmid17296878-
dc.identifier.scopuseid_2-s2.0-33847006936en_US
dc.identifier.hkuros126506-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33847006936&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume167en_US
dc.identifier.issue3en_US
dc.identifier.spage239en_US
dc.identifier.epage245en_US
dc.identifier.isiWOS:000244163200003-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridWhite, HD=7402382203en_US
dc.identifier.scopusauthoridGruber, M=35870258200en_US
dc.identifier.scopusauthoridFeyzi, J=6603002916en_US
dc.identifier.scopusauthoridKaatz, S=6603113635en_US
dc.identifier.scopusauthoridTse, HF=7006070805en_US
dc.identifier.scopusauthoridHusted, S=7006670291en_US
dc.identifier.scopusauthoridAlbers, GW=26643607400en_US

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