Factors influencing warfarin control in Australia and Singapore

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Author(s)
Bernaitis, Nijole
Ching, Chi Keong
Teo, Siew Chong
Chen, Liping
Badrick, Tony
Davey, Andrew K
Crilly, Julia
Anoopkumar-Dukie, Shailendra
Griffith University Author(s)
Year published
2017
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Introduction: Warfarin is widely used for patients with non-valvular atrial fibrillation (NVAF). Variations in warfarin
control, as measured by time in therapeutic range (TTR), have been reported across different regions and
ethnicities, particularly between Western and Asian countries. However, there is limited data on comparative
factors influencing warfarin control in Caucasian and Asian patients. Therefore, the aim of this study was to determine
warfarin control and potential factors influencing this in patients with NVAF in Australia and Singapore.
Methods: Retrospective data was collected for patients receiving warfarin ...
View more >Introduction: Warfarin is widely used for patients with non-valvular atrial fibrillation (NVAF). Variations in warfarin control, as measured by time in therapeutic range (TTR), have been reported across different regions and ethnicities, particularly between Western and Asian countries. However, there is limited data on comparative factors influencing warfarin control in Caucasian and Asian patients. Therefore, the aim of this study was to determine warfarin control and potential factors influencing this in patients with NVAF in Australia and Singapore. Methods: Retrospective data was collected for patients receiving warfarin for January to June 2014 in Australia and Singapore. TTR was calculated for individuals with mean patient TTR used for analysis. Possible influential factors on TTR were analysed including age, gender, concurrent co-morbidities, and concurrent medication. Results: The mean TTR was significantly higher in Australia (82%) than Singapore (58%). At both sites, chronic kidney disease significantly lowered this TTR. Further factors influencing control were anaemia and age b 60 years in Australia, and vascular disease, CHA2DS2-VASc score of 6, and concurrent platelet inhibitor therapy in Singapore. Discussion: Warfarin control was significantly higher in Australia compared to Singapore, however chronic kidney disease reduced control at both sites. The different levels of control in these two countries, together with patient factors further reducing control may impact on anticoagulant choice in these countries with better outcomes from warfarin in Australia compared to Singapore.
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View more >Introduction: Warfarin is widely used for patients with non-valvular atrial fibrillation (NVAF). Variations in warfarin control, as measured by time in therapeutic range (TTR), have been reported across different regions and ethnicities, particularly between Western and Asian countries. However, there is limited data on comparative factors influencing warfarin control in Caucasian and Asian patients. Therefore, the aim of this study was to determine warfarin control and potential factors influencing this in patients with NVAF in Australia and Singapore. Methods: Retrospective data was collected for patients receiving warfarin for January to June 2014 in Australia and Singapore. TTR was calculated for individuals with mean patient TTR used for analysis. Possible influential factors on TTR were analysed including age, gender, concurrent co-morbidities, and concurrent medication. Results: The mean TTR was significantly higher in Australia (82%) than Singapore (58%). At both sites, chronic kidney disease significantly lowered this TTR. Further factors influencing control were anaemia and age b 60 years in Australia, and vascular disease, CHA2DS2-VASc score of 6, and concurrent platelet inhibitor therapy in Singapore. Discussion: Warfarin control was significantly higher in Australia compared to Singapore, however chronic kidney disease reduced control at both sites. The different levels of control in these two countries, together with patient factors further reducing control may impact on anticoagulant choice in these countries with better outcomes from warfarin in Australia compared to Singapore.
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Journal Title
Thrombosis Research
Volume
157
Copyright Statement
© 2017 Elsevier Ireland Ltd. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
Subject
Clinical sciences
Clinical sciences not elsewhere classified
Cardiovascular medicine and haematology