Kulo Aida, Kusturica Jasna, Kapić Elvedina, Becić Fahir, Rakanović-Todić Maida, Burnazović-Ristić Lejla, Mehmedović Amila, Lepar Orhan, Mulabegović Nedzad
Institute of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Sarajevo, Sarajevo, Bosnia & Herzegovina.
Med Glas (Zenica). 2011 Feb;8(1):9-14.
To evaluate differences in the treatment quality between often used oral anticoagulants, warfarin and acenocoumarol in patients with nonvalvular atrial fibrillation (NVAF).
This was an observational, comparative, one-year clinical study, conducted in the Blood Transfusion Institute of Sarajevo, Bosnia & Herzegovina. All patients who were using warfarin/ acenocoumarol and monitored were eligible. Patients who met inclusion criteria (the age of 40-80, diagnosed NVAF, CHADS index score > or = 2, the planned long-term treatment) were includes in two parallel groups of 60 patients, composed according to the warfarin/acenocoumarol treatment as well as the gender and age. Routinely measured International normalised ratio (INR) values were the basic parameter for individual quality and stability assessment.
All average, monthly INR values were in therapeutic range (2.0-3.0) in both therapeutic groups. There were no significant differences either in the number of therapeutic INR values per patient (50.53 +/- 23.72% vs. 51.74 +/- 26.68%, P = 0.795) or in individual quality of treatment: > 50% therapeutic INR values (60.0% vs. 64.9%, P = 0.721) and > 75% therapeutic INR values (18.3% vs. 22.8%, P = 0.714) in the warfarin and acenocoumarol group, respectively. Significantly better stability was determined for acenocoumarol as compared with warfarin treatment in terms of a longer period of the total observed time during which therapeutic INR values were stable (37.6% vs. 35.7%, P = 0.0002).
Both drugs have shown similar quality of individual anticoagulation control, but acenocoumarol have shown significantly better anticoagulation stability with therapeutic INR values covering significantly longer time of treatment.
评估常用口服抗凝剂华法林和醋硝香豆素在非瓣膜性心房颤动（NVAF）患者中的治疗质量差异。
这是一项在波斯尼亚和黑塞哥维那萨拉热窝输血研究所进行的为期一年的观察性、对比性临床研究。所有正在使用华法林/醋硝香豆素并接受监测的患者均符合条件。符合纳入标准（年龄40 - 80岁、诊断为NVAF、CHADS指数评分≥2、计划进行长期治疗）的患者被纳入两个平行组，每组60例，根据华法林/醋硝香豆素治疗以及性别和年龄进行分组。常规测量的国际标准化比值（INR）值是个体质量和稳定性评估的基本参数。
两个治疗组的所有平均每月INR值均在治疗范围内（2.0 - 3.0）。每位患者的治疗性INR值数量（50.53±23.72%对51.74±26.68%，P = 0.795）或个体治疗质量方面均无显著差异：华法林组和醋硝香豆素组中治疗性INR值>50%（60.0%对64.9%，P = 0.721）以及>75%（18.3%对22.8%，P = 0.714）。与华法林治疗相比，醋硝香豆素在治疗性INR值稳定的总观察时间更长方面显示出显著更好的稳定性（37.6%对35.7%，P = 0.0002）。
两种药物在个体抗凝控制质量方面表现相似，但醋硝香豆素在治疗性INR值覆盖治疗时间显著更长方面显示出显著更好的抗凝稳定性。
