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Updated: Jul 6, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
[Monitoring age-dependent effect of anticoagulation treatment in patients with atrial fibrillation]
T Hnátek1, D Zogala, L Kameník
1Kardiologické oddĕlení Interní kliniky 1. lékarské fakulty UK a UVN Praha. TomasHnatek@mediclub.cz
Insights
Warfarin sodium treatment for atrial fibrillation is effective across age groups, with approximately 47% of patients achieving therapeutic anticoagulation. Monitoring by general practitioners or internists showed similar outcomes, and severe complications were low.
Area of Science:
- Cardiology
- Pharmacology
- Geriatrics
Context:
- Atrial fibrillation necessitates oral anticoagulation, commonly with warfarin sodium.
- Elderly patients and treatment monitoring by different specialists are key factors influencing anticoagulation efficacy.
- Assessing treatment effectiveness and complications in a real-world hospital setting is crucial.
Purpose:
- To evaluate the effectiveness of warfarin sodium treatment in atrial fibrillation patients.
- To determine if age or the type of medical monitoring impacts anticoagulation control.
- To assess the rate of severe complications associated with warfarin therapy.
Summary:
- The study found that approximately 47% of atrial fibrillation patients achieved the target INR range of 2.0-3.5.
- Treatment efficacy did not significantly differ between patients younger than 75 and older patients.
- Monitoring by general practitioners versus internists yielded comparable anticoagulation control rates (49% vs. 52%).
- Severe complications occurred in only 3.4% of patients.
Impact:
- Warfarin sodium therapy demonstrates consistent effectiveness in atrial fibrillation patients regardless of age.
- The choice of monitoring physician (GP vs. internist) does not appear to influence anticoagulation control.
- The low rate of severe complications suggests warfarin is a relatively safe treatment option for this population.
Abstract:
Oral anticoagulation treatment with dicumarol preparations (warfarin sodium) is the standard in patients with atrial fibrillation. The effect of treatment depends on many factors, especially in elderly patients. In the study, we assessed the effect of treatment in patients with atrial fibrillation hospitalized in our cardiology ward from 2004 to 2005, in the form of a telephone survey (who controlled the treatment--general practitioner or internist?, the last 2 INR results, complications). INR 2.0-3.5 is considered an efficient therapeutic range. The proportion of permanently correctly anticoagulated patients is approximately 47% across the whole age range, the hypothesis of lower efficiency of treatment in elderly patients does not apply (48% of efficiently anticoagulated patients younger than 75 years vs. 46% of older patients--however, the study does not include polymorbid patients who could not take warfarin at all!) The fact whether a patient is monitored by a general practitioner or an outpatient specialist does not make any difference (49% of anticoagulated patients monitored by a general practitioner vs. 52% of patients monitored by an internist). The percentage of severe complications is relatively low (3.4%).
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