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Analysis and comparison of two low-dosage warfarin regimens in Chinese patients

Guy-Armel Bounda*, Cosette Ngarambe, Weihong Ge, Feng Yu   

  1. 1. Department of Clinical Pharmacy, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China
    2. Medical School, Southeast University, Nanjing 210096, China
    3. The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
  • Received:2012-08-12 Revised:2012-11-20 Online:2013-01-20 Published:2013-01-20
  • Contact: Guy-Armel Bounda*

Abstract:

Oral anticoagulation therapy with warfarin is used to prevent and treat venous and arterial thrombosis and embolism. Its narrow therapeutic index should be monitored carefully in order to reach the desired outcomes. The complexity of the pharmacokinetic and pharmacodynamics profile of warfarin makes it a challenge to use during treatment. Its manufacturing characteristics play a key role in its dosage. The aim of this study is to examine and evaluate the effect of two different warfarin regimens in Chinese patients. A cross-sectional study design was adopted. Medical records of all patients (n = 368) who received warfarin therapy in cardio-thoracic surgery wards between Sep. 2008 and Dec. 2009 were reviewed. Details of antithrombotic results of international normalized ratio (INR) monitoring were obtained. Statistical analysis was performed to assess factors predictive of INR therapeutic range at patients’ discharge time according to different warfarin regimens (2.5 mg in China and 3.0 mg in USA). The patients’ mean age was (48.23±12.96) years. The percentage of patients within the INR therapeutic range in the group treated with 2.5 mg warfarin (35.17%) was much lower than that in group treated with 3.0 mg warfarin (47.72%). Therefore, a significance difference was observed (P = 0.032<0.05). In this study, statistical values have shown that most of the patients were related to medical case requesting INR target range of 1.8-2.2 and 2.0-2.5, respectively. There was a statistically significant difference between the two groups. The study showed that the 2.5 mg-warfarin regimen was less suitable than the 3.0 mg-warfarin regimen. Medication regimen should be simplified as much as possible, especially during different treatment period.

Key words: Anticoagulation, Chinese patients, Dose, INR, Low warfarin regimen

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