Optimal INR level in patients with atrial fibrillation with EHRA type 2 valvular heart disease receiving warfarin

Journal of Arrhythmia
Sirote LuengsupabulRatikorn Methavigul

Abstract

To date, there has been no study that compares the efficacy and safety of warfarin in atrial fibrillation (AF) patients with Evaluated Heartvalves, Rheumatic or Artificial (EHRA) type 2 valvular heart disease (VHD). This study was conducted to determine the optimal INR in these patients. This retrospective study enrolled AF patients with EHRA type 2 VHD receiving warfarin in Central Chest Institute of Thailand between January 2016 and December 2018. The incidence density of thromboembolic or bleeding events was calculated. The International normalized ratio (INR) was classified into six groups (less than 1.50, 1.50 to 1.99, 2.00 to 2.49, 2.50 to 2.99, 3.00 to 3.49, and 3.50 or more). The optimal INR level was defined as the lowest incidence density of thromboembolic events and bleeding complications. A total of 200 AF patients with EHRA type 2 VHD receiving warfarin were enrolled, contributing to 289 patient-years of observation period. There were 13 thromboembolic events (4.5 per 100 patient-years) and 16 bleeding events (5.5 per 100 patient-years). The incidence density of thromboembolic events was significantly increased in the INR level below 2.00 (P = .03), while the INR level of 3.50 or more was significantly increased in...Continue Reading

References

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