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The risk of overanticoagulation in patients with heart failure on coumarin anticoagulants.
- Source :
-
British journal of haematology [Br J Haematol] 2004 Oct; Vol. 127 (1), pp. 85-9. - Publication Year :
- 2004
-
Abstract
- Heart failure has been identified as a risk factor for increased coumarin anticoagulant responsiveness in several small-scale experiments. Epidemiological studies quantifying the risk of overanticoagulation by heart failure in a non-selected population on coumarins are scarce. Therefore, we investigated whether patients with heart failure have an increased risk of overanticoagulation and determined the effect of incidental heart failure on coumarin dose requirements. A cohort study of all patients was performed from an outpatient anticoagulation clinic treated with acenocoumarol or phenprocoumon between 1 January 1990 and 1 January 2000. All cohort members were followed until the first occurrence of an international normalized ratio (INR) > or = 6.0, the last INR assessment, death, loss to follow-up, or end of the study period. Of the 1077 patients in the cohort, 396 developed an INR > or = 6.0. The risk of overanticoagulation was 1.66 [95% confidence interval (CI): 1.33-2.07] for cases of prevalent heart failure and 1.91 (95%CI: 1.31-2.79) for incidental cases. The decrease in dose requirements in patients with incidental heart failure showed a significant trend from the fifth INR measurement preceding the date of incidental heart failure to the third measurement after this date. Heart failure is an independent risk factor for overanticoagulation. Therefore, patients with heart failure should be closely monitored to prevent potential bleeding complications.<br /> (Copyright 2004 Blackwell Publishing Ltd)
- Subjects :
- Acenocoumarol pharmacology
Aged
Anticoagulants pharmacology
Blood Coagulation drug effects
Drug Administration Schedule
Drug Monitoring
Female
Follow-Up Studies
Humans
International Normalized Ratio
Male
Middle Aged
Phenprocoumon pharmacology
Risk Factors
Acenocoumarol administration & dosage
Anticoagulants administration & dosage
Heart Failure blood
Phenprocoumon administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 0007-1048
- Volume :
- 127
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- British journal of haematology
- Publication Type :
- Academic Journal
- Accession number :
- 15384981
- Full Text :
- https://doi.org/10.1111/j.1365-2141.2004.05162.x