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Randomized Comparison of Two Approaches to Initial Warfarin Dosing: Time in Therapeutic Range of International
L N Mishchenko1, Oleg V Averkov2, I G Gordeev3
1ФГБОУ ВО «РНИМУ им. Н. И. Пирогова»; «ГКБ № 15 имени О. М. Филатова».
Aim:
To perform a randomized, open-label comparison of average time in therapeutic range (TTR) of international normalized ratio (INR) using two approaches to initial warfarin dosing during hospitalization: the standard method and the one using individual patient characteristics (clinical algorithm - the studied approach).
Materials And Methods:
We randomly assigned 60 patients with different indications for vitamin K antagonist therapy to the studied approach (n=31, intervention group) or to the standard method (n=29, control group). А target INR range for all patients was 2.0 to 3.0.
Results:
The average TTR and portions of INR values within target range during the whole time of drug dosing turned out to be small. TTR was 22.4% with standard method and 21.4% with clinical algorithm, which was well below desired 60%.
Conclusion:
The opportunities for achieving target INR in inpatient settings, regardless of warfarin dosing regimen, are limited.
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