Could the De Ritis ratio be a marker to predict the higher international normalized ratio values?

Area of Science:

• Hepatology and Clinical Biochemistry
• Pharmacology and Therapeutics

Background:

• Warfarin therapy requires careful monitoring of the international normalized ratio (INR) to ensure efficacy and prevent complications.
• The De Ritis ratio, calculated as the ratio of aspartate aminotransferase (AST) to alanine aminotransferase (ALT) levels, is a marker of liver injury.
• Investigating novel biomarkers for predicting INR fluctuations can improve patient management.

Purpose of the Study:

• To determine the prognostic significance of the De Ritis ratio in predicting elevated INR values in patients undergoing warfarin treatment.
• To explore the association between liver enzyme ratios and anticoagulation control.

Main Methods:

• A retrospective study was conducted on 357 patients receiving warfarin.
• Patients were categorized into three groups based on their INR values: <2, 2-3.5, and >3.5.
• Statistical analysis was performed to compare demographic and laboratory data, including the De Ritis ratio, across the INR groups.

Main Results:

• A significant difference in the De Ritis ratio was observed among the INR groups (p < 0.001).
• The median De Ritis ratio was notably higher in patients with INR values above 3.5 compared to those with lower INR levels.
• Lymphocyte counts also showed significant differences between groups.

Conclusions:

• A high De Ritis ratio is significantly correlated with elevated INR values in patients on warfarin.
• The De Ritis ratio may serve as a useful prognostic indicator for predicting higher INR levels, aiding in the management of warfarin therapy.