Oncotarget

Research Papers: Gerotarget (Focus on Aging):

Age is associated with time in therapeutic range for warfarin therapy in patients with atrial fibrillation

Leiliane Rodrigues Marcatto, Luciana Sacilotto, Francisco Carlos da Costa Darrieux, Denise Tessariol Hachul, Maurício Ibrahim Scanavacca, Jose Eduardo Krieger, Alexandre Costa Pereira and Paulo Caleb Junior Lima Santos _

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Oncotarget. 2016; 7:54194-54199. https://doi.org/10.18632/oncotarget.10944

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Abstract

Leiliane Rodrigues Marcatto1,*, Luciana Sacilotto2,*, Francisco Carlos da Costa Darrieux2, Denise Tessariol Hachul2, Maurício Ibrahim Scanavacca2, Jose Eduardo Krieger1, Alexandre Costa Pereira1 and Paulo Caleb Junior Lima Santos1

1 Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil

2 Clinical Cardiology Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil

* These authors have contributed equally to this work

Correspondence to:

Alexandre Costa Pereira, email:

Paulo Caleb Junior Lima Santos, email:

Keywords: warfarin, TTR, age, atrial fibrillation, polymorphisms, Gerotarget

Received: May 03, 2016 Accepted: July 19, 2016 Published: July 29, 2016

Abstract

Background: Warfarin is the most prescribed oral anticoagulant used for preventing stroke in patients with atrial fibrillation. Time in the therapeutic range (TTR) has been accepted as the best method to evaluate the quality of warfarin therapy. The main aim of the present study was to evaluate the impact of variables on the time in the therapeutic range for warfarin therapy in patients with atrial fibrillation from a referral cardiovascular hospital.

Methods: This retrospective study included 443 patients were included (190 patients with age < 65 years and 253 patients with age ≥65 years) from 2011 to 2014 and TTR was computed according to Rosendaal’s method.

Results: Patients with age ≥65 years had higher TTR value (67±22%) compared with patients with < 65 years (60±24%) (p = 0.004). In a linear regression model, only age ≥65 years emerged as a significant predictor of greater TTR values. In multivariate logistic regression model, the variable age ≥65 years was associated with higher OR for having a TTR higher than the median value (OR = 2.17, p < 0.001).

Conclusion: We suggest that the age influenced TTR through greater drug adherence. Strategies for increasing drug adherence might improve quality of warfarin anticoagulation.


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