Optimal INR level in elderly and non-elderly patients with atrial fibrillation receiving warfarin: a report from the COOL-AF nationwide registry in Thailand

作     者：Rungroj Krittayaphong Rapeephon Kunjara-Na-Ayudhya Pornchai Ngamjanyaporn Smonporn Boonyaratavej Chulalak Komoltri Ahthit Yindeengam Piyamitr Sritara Gregory YHLip Rungroj Krittayaphong;Rapeephon Kunjara-Na-Ayudhya;Pornchai Ngamjanyaporn;Smonporn Boonyaratavej;Chulalak Komoltri;Ahthit Yindeengam;Piyamitr Sritara;Gregory Y.H.Lip

作者机构：Division of CardiologyDepartment of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand Department of CardiologyVichaiyut Hospital and Medical CenterBangkokThailand Department of CardiologyChonburi HospitalChonburiThailand Division of CardiologyDepartment of MedicineFaculty of MedicineChulalongkorn UniversityBangkokThailand Department of Research PromotionFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand Her Majesty Cardiac CenterFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand Division of CardiologyDepartment of MedicineFaculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand Liverpool Centre for Cardiovascular ScienceUniversity of Liverpool and Liverpool Heart&Chest HospitalLiverpoolUnited Kingdom Aalborg Thrombosis Research UnitDepartment of Clinical MedicineAalborg UniversityAalborgDenmark 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2020年第17卷第10期

页      面：612-620页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：the Health System Research Institute(59-053) the Heart Association of Thailand under the Royal Patronage of H.M.the King.All authors had no conflicts of interest to disclose.The authors gratefully acknowledge Pontawee Kaewcomdee and Olaree Chaiphet for data management,and all investigators and nurse coordinators of the COOL-AF registry 

主　　题：Bleeding Ischemic stroke Non-valvular atrial fibrillation Optimal international normalized ratio Thailand Warfarin 

摘      要：Background Asian population are at increased risk of bleeding during the warfarin treatment,so the recommended optimal international normalized ratio(INR)level may be lower in Asians than in *** aim of this prospective multicenter study was to determine the optimal INR level in Thai patients with non-valvular atrial fibrillation(NVAF).Methods Patients with NVAF who were on warfarin for stroke prevention were recruited from 27 hospitals in the nationwide COOL-AF registry in *** collected demographic data,medical history,risk factors for stroke and bleeding,concomitant disease,electrocardiogram and laboratory data including INR and antithrombotic *** measurements included ischemic stroke/transient ischemic attack(TIA)and major *** INR level was assessed by the calculation of incidence density for six INR ranges(1.5,1.5–1.99,2–2.49,2.5–2.99,3–3.49,and≥3.5).Results A total of 2,232 patients were *** mean age of patients was 68.5±10.6 *** mean follow-up duration was 25.7±10.6 *** were 63 ischemic stroke/TIA and 112 major bleeding *** lowest prevalence of ischemic stroke/TIA and major bleeding events occurred within the INR range of 2.0–2.99 for patients70 years and 1.5–2.99 for patients≥70 *** The INR range associated with the lowest risk of ischemic stroke/TIA and bleeding in the Thai population was 2.0–2.99 for patients70 years and 1.5–2.99 for patients≥70 *** rates of major bleeding and ischemic stroke/TIA were both higher than the rates reported in Western population.