Patient Factors against Stable Control of Warfarin Therapy for Japanese Non-valvular Atrial Fibrillation Patients

Hideharu Tomita, Toshiaki Kadokami, Hidetoshi Momii, Natsumi Kawamura, Masayoshi Yoshida, Tetsuji Inou, Yutaka Fukuizumi, Makoto Usui, Kouta Funakoshi, Satoshi Yamada, Tohru Aomori, Koujiro Yamamoto, Tsukasa Uno, Shin Ichi Ando

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Introduction Effectiveness and safety of warfarin therapy for non-valvular atrial fibrillation (NVAF) patients are strongly associated with its stability presented such as time in therapeutic range (TTR) of PT-INR. However, the factors that affect TTR have not been fully elucidated in Japan where majority of patients are controlled within the range of 1.6-2.6 of PT-INR irrespective of the age. Methods We retrospectively analyzed 163 NVAF patients taking warfarin to determine the factors that affect TTR including metabolic enzymes polymorphisms after TTR calculation with both the standard PT-INR range and the actual control range of 1.6-2.6. Results Overall TTR calculated using Japanese Guideline was 69.7 ± 25.1% (< 70 and ≥ 70 years; 49.6 ± 24.8% and 77.8 ± 20.3%, respectively). After confirming that PT-INR values in patients < 70 years distributed in the same range as in those ≥ 70 years, as in a Japanese large cohort, we recalculated TTR of those < 70 years with 1.6-2.6 of PT-INR and found that it was 79.5 ± 20.1%. Poor control of this new TTR were significantly associated with the lower height, the higher serum creatinine, the lower creatinine clearance, female gender, and presence of congestive heart failure, (p < 0.05 respectively). Multivariate analysis revealed female gender and presence of congestive heart failure as independent predictor of the lower TTR (p < 0.05, p < 0.01, respectively). Polymorphism of CYP2C9 and VKORC1 were related to the dosage of warfarin but not determinant of TTR. Conclusions When evaluated using a range of PT-INR actually used in Japan, TTR is generally well controlled and female gender and presence of congestive heart failure significantly affected the poorer TTR control.

Original languageEnglish
Pages (from-to)537-542
Number of pages6
JournalThrombosis Research
Volume132
Issue number5
DOIs
Publication statusPublished - 2013 Nov
Externally publishedYes

Fingerprint

Warfarin
Atrial Fibrillation
International Normalized Ratio
Therapeutics
Heart Failure
Creatinine
Japan
Multivariate Analysis
Guidelines
Safety

Keywords

  • Non-valvular Atrial Fibrillation
  • Time in therapeutic range
  • Warfarin

ASJC Scopus subject areas

  • Hematology

Cite this

Tomita, H., Kadokami, T., Momii, H., Kawamura, N., Yoshida, M., Inou, T., ... Ando, S. I. (2013). Patient Factors against Stable Control of Warfarin Therapy for Japanese Non-valvular Atrial Fibrillation Patients. Thrombosis Research, 132(5), 537-542. https://doi.org/10.1016/j.thromres.2013.09.003

Patient Factors against Stable Control of Warfarin Therapy for Japanese Non-valvular Atrial Fibrillation Patients. / Tomita, Hideharu; Kadokami, Toshiaki; Momii, Hidetoshi; Kawamura, Natsumi; Yoshida, Masayoshi; Inou, Tetsuji; Fukuizumi, Yutaka; Usui, Makoto; Funakoshi, Kouta; Yamada, Satoshi; Aomori, Tohru; Yamamoto, Koujiro; Uno, Tsukasa; Ando, Shin Ichi.

In: Thrombosis Research, Vol. 132, No. 5, 11.2013, p. 537-542.

Research output: Contribution to journalArticle

Tomita, H, Kadokami, T, Momii, H, Kawamura, N, Yoshida, M, Inou, T, Fukuizumi, Y, Usui, M, Funakoshi, K, Yamada, S, Aomori, T, Yamamoto, K, Uno, T & Ando, SI 2013, 'Patient Factors against Stable Control of Warfarin Therapy for Japanese Non-valvular Atrial Fibrillation Patients', Thrombosis Research, vol. 132, no. 5, pp. 537-542. https://doi.org/10.1016/j.thromres.2013.09.003
Tomita, Hideharu ; Kadokami, Toshiaki ; Momii, Hidetoshi ; Kawamura, Natsumi ; Yoshida, Masayoshi ; Inou, Tetsuji ; Fukuizumi, Yutaka ; Usui, Makoto ; Funakoshi, Kouta ; Yamada, Satoshi ; Aomori, Tohru ; Yamamoto, Koujiro ; Uno, Tsukasa ; Ando, Shin Ichi. / Patient Factors against Stable Control of Warfarin Therapy for Japanese Non-valvular Atrial Fibrillation Patients. In: Thrombosis Research. 2013 ; Vol. 132, No. 5. pp. 537-542.
@article{8ec67f3a3b66442abfdb481708182735,
title = "Patient Factors against Stable Control of Warfarin Therapy for Japanese Non-valvular Atrial Fibrillation Patients",
abstract = "Introduction Effectiveness and safety of warfarin therapy for non-valvular atrial fibrillation (NVAF) patients are strongly associated with its stability presented such as time in therapeutic range (TTR) of PT-INR. However, the factors that affect TTR have not been fully elucidated in Japan where majority of patients are controlled within the range of 1.6-2.6 of PT-INR irrespective of the age. Methods We retrospectively analyzed 163 NVAF patients taking warfarin to determine the factors that affect TTR including metabolic enzymes polymorphisms after TTR calculation with both the standard PT-INR range and the actual control range of 1.6-2.6. Results Overall TTR calculated using Japanese Guideline was 69.7 ± 25.1{\%} (< 70 and ≥ 70 years; 49.6 ± 24.8{\%} and 77.8 ± 20.3{\%}, respectively). After confirming that PT-INR values in patients < 70 years distributed in the same range as in those ≥ 70 years, as in a Japanese large cohort, we recalculated TTR of those < 70 years with 1.6-2.6 of PT-INR and found that it was 79.5 ± 20.1{\%}. Poor control of this new TTR were significantly associated with the lower height, the higher serum creatinine, the lower creatinine clearance, female gender, and presence of congestive heart failure, (p < 0.05 respectively). Multivariate analysis revealed female gender and presence of congestive heart failure as independent predictor of the lower TTR (p < 0.05, p < 0.01, respectively). Polymorphism of CYP2C9 and VKORC1 were related to the dosage of warfarin but not determinant of TTR. Conclusions When evaluated using a range of PT-INR actually used in Japan, TTR is generally well controlled and female gender and presence of congestive heart failure significantly affected the poorer TTR control.",
keywords = "Non-valvular Atrial Fibrillation, Time in therapeutic range, Warfarin",
author = "Hideharu Tomita and Toshiaki Kadokami and Hidetoshi Momii and Natsumi Kawamura and Masayoshi Yoshida and Tetsuji Inou and Yutaka Fukuizumi and Makoto Usui and Kouta Funakoshi and Satoshi Yamada and Tohru Aomori and Koujiro Yamamoto and Tsukasa Uno and Ando, {Shin Ichi}",
year = "2013",
month = "11",
doi = "10.1016/j.thromres.2013.09.003",
language = "English",
volume = "132",
pages = "537--542",
journal = "Thrombosis Research",
issn = "0049-3848",
publisher = "Elsevier Limited",
number = "5",

}

TY - JOUR

T1 - Patient Factors against Stable Control of Warfarin Therapy for Japanese Non-valvular Atrial Fibrillation Patients

AU - Tomita, Hideharu

AU - Kadokami, Toshiaki

AU - Momii, Hidetoshi

AU - Kawamura, Natsumi

AU - Yoshida, Masayoshi

AU - Inou, Tetsuji

AU - Fukuizumi, Yutaka

AU - Usui, Makoto

AU - Funakoshi, Kouta

AU - Yamada, Satoshi

AU - Aomori, Tohru

AU - Yamamoto, Koujiro

AU - Uno, Tsukasa

AU - Ando, Shin Ichi

PY - 2013/11

Y1 - 2013/11

N2 - Introduction Effectiveness and safety of warfarin therapy for non-valvular atrial fibrillation (NVAF) patients are strongly associated with its stability presented such as time in therapeutic range (TTR) of PT-INR. However, the factors that affect TTR have not been fully elucidated in Japan where majority of patients are controlled within the range of 1.6-2.6 of PT-INR irrespective of the age. Methods We retrospectively analyzed 163 NVAF patients taking warfarin to determine the factors that affect TTR including metabolic enzymes polymorphisms after TTR calculation with both the standard PT-INR range and the actual control range of 1.6-2.6. Results Overall TTR calculated using Japanese Guideline was 69.7 ± 25.1% (< 70 and ≥ 70 years; 49.6 ± 24.8% and 77.8 ± 20.3%, respectively). After confirming that PT-INR values in patients < 70 years distributed in the same range as in those ≥ 70 years, as in a Japanese large cohort, we recalculated TTR of those < 70 years with 1.6-2.6 of PT-INR and found that it was 79.5 ± 20.1%. Poor control of this new TTR were significantly associated with the lower height, the higher serum creatinine, the lower creatinine clearance, female gender, and presence of congestive heart failure, (p < 0.05 respectively). Multivariate analysis revealed female gender and presence of congestive heart failure as independent predictor of the lower TTR (p < 0.05, p < 0.01, respectively). Polymorphism of CYP2C9 and VKORC1 were related to the dosage of warfarin but not determinant of TTR. Conclusions When evaluated using a range of PT-INR actually used in Japan, TTR is generally well controlled and female gender and presence of congestive heart failure significantly affected the poorer TTR control.

AB - Introduction Effectiveness and safety of warfarin therapy for non-valvular atrial fibrillation (NVAF) patients are strongly associated with its stability presented such as time in therapeutic range (TTR) of PT-INR. However, the factors that affect TTR have not been fully elucidated in Japan where majority of patients are controlled within the range of 1.6-2.6 of PT-INR irrespective of the age. Methods We retrospectively analyzed 163 NVAF patients taking warfarin to determine the factors that affect TTR including metabolic enzymes polymorphisms after TTR calculation with both the standard PT-INR range and the actual control range of 1.6-2.6. Results Overall TTR calculated using Japanese Guideline was 69.7 ± 25.1% (< 70 and ≥ 70 years; 49.6 ± 24.8% and 77.8 ± 20.3%, respectively). After confirming that PT-INR values in patients < 70 years distributed in the same range as in those ≥ 70 years, as in a Japanese large cohort, we recalculated TTR of those < 70 years with 1.6-2.6 of PT-INR and found that it was 79.5 ± 20.1%. Poor control of this new TTR were significantly associated with the lower height, the higher serum creatinine, the lower creatinine clearance, female gender, and presence of congestive heart failure, (p < 0.05 respectively). Multivariate analysis revealed female gender and presence of congestive heart failure as independent predictor of the lower TTR (p < 0.05, p < 0.01, respectively). Polymorphism of CYP2C9 and VKORC1 were related to the dosage of warfarin but not determinant of TTR. Conclusions When evaluated using a range of PT-INR actually used in Japan, TTR is generally well controlled and female gender and presence of congestive heart failure significantly affected the poorer TTR control.

KW - Non-valvular Atrial Fibrillation

KW - Time in therapeutic range

KW - Warfarin

UR - http://www.scopus.com/inward/record.url?scp=84886099035&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84886099035&partnerID=8YFLogxK

U2 - 10.1016/j.thromres.2013.09.003

DO - 10.1016/j.thromres.2013.09.003

M3 - Article

VL - 132

SP - 537

EP - 542

JO - Thrombosis Research

JF - Thrombosis Research

SN - 0049-3848

IS - 5

ER -