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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Age- and weight-adjusted warfarin initiation nomogram for ischaemic stroke patients
1Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
European Journal of Neurology
|June 8, 2012
Summary
An age- and weight-adjusted warfarin initiation nomogram (AW-WIN) significantly reduced time to therapeutic anticoagulation in ischemic stroke patients. This warfarin dosing method also lowered the risk of excessive anticoagulation, proving safe and efficient.
Area of Science:
- Cardiology
- Neurology
- Pharmacology
Background:
- Warfarin dosing guidelines for ischemic stroke patients are lacking.
- Physician-determined warfarin dosing (PDWD) may lead to suboptimal anticoagulation.
- Developing standardized dosing nomograms is crucial for patient safety and treatment efficacy.
Purpose of the Study:
- To develop and evaluate an age- and weight-adjusted warfarin initiation nomogram (AW-WIN).
- To compare the efficacy and safety of AW-WIN against physician-determined warfarin dosing (PDWD) in ischemic stroke patients.
- To assess the time to achieve therapeutic international normalized ratios (INRs) and the incidence of excessive anticoagulation.
Main Methods:
- An age- and weight-adjusted warfarin initiation nomogram (AW-WIN) was administered to 104 acute ischemic stroke patients.
- A historical control group of 96 patients receiving physician-determined warfarin dosing (PDWD) was used for comparison.
- Time to therapeutic INRs and rates of excessive anticoagulation were compared between the AW-WIN and PDWD groups.
Main Results:
- The AW-WIN group achieved a therapeutic INR ≥2.0 significantly faster than the PDWD group (4.9 vs. 6.2 days).
- AW-WIN demonstrated a higher proportion of patients within the therapeutic INR range (2-3) at 5 days.
- The rate of excessive anticoagulation (INR ≥3.5) was significantly lower in the AW-WIN group compared to PDWD.
Conclusions:
- The AW-WIN nomogram is an effective tool for accelerating anticoagulation in acute ischemic stroke.
- AW-WIN enhances warfarin safety by reducing the risk of excessive anticoagulation during hospitalization.
- This age- and weight-adjusted nomogram represents an efficient and safe anticoagulation strategy for ischemic stroke patients.
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