土耳其不同地理区域的华法林治疗范围时间和出血并发症：WARFARIN-TR 研究的亚组分析。
The Time in Therapeutic Range and Bleeding Complications of Warfarin in Different Geographic Regions of Turkey: A Subgroup Analysis of WARFARIN-TR Study.
机构信息
Department of Cardiology, Ege University School of Medicine, İzmir, Turkey.
Department of Cardiology, Mersin University School of Medicine, Mersin, Turkey.
出版信息
Balkan Med J. 2017 Aug 4;34(4):349-355. doi: 10.4274/balkanmedj.2016.1617. Epub 2017 Apr 6.
BACKGROUND
The time in therapeutic range values may vary between different geographical regions of Turkey in patients vitamin K antagonist therapy.
AIMS
To evaluate the time in therapeutic range percentages, efficacy, safety and awareness of warfarin according to the different geographical regions in patients who participated in the WARFARIN-TR study (The Awareness, Efficacy, Safety and Time in Therapeutic Range of Warfarin in the Turkish population) in Turkey.
STUDY DESIGN
Cross-sectional study.
METHODS
The WARFARIN-TR study includes 4987 patients using warfarin and involved regular international normalized ratio monitoring between January 1, 2014 and December 31, 2014. Patients attended follow-ups for 12 months. The sample size calculations were analysed according to the density of the regional population and according to Turkish Statistical Institute data. The time in therapeutic range was calculated according to F.R. Roosendaal's algorithm. Awareness was evaluated based on the patients' knowledge of the effect of warfarin and food-drug interactions with simple questions developed based on a literature review.
RESULTS
The Turkey-wide time in therapeutic range was reported as 49.5%±22.9 in the WARFARIN-TR study. There were statistically significant differences between regions in terms of time in therapeutic range (p>0.001). The highest rate was reported in the Marmara region (54.99%±20.91) and the lowest was in the South-eastern Anatolia region (41.95±24.15) (p>0.001). Bleeding events were most frequently seen in Eastern Anatolia (41.6%), with major bleeding in the Aegean region (5.11%) and South-eastern Anatolia (5.36%). There were statistically significant differences between the regions in terms of awareness (p>0.001).
CONCLUSION
Statistically significant differences were observed in terms of the efficacy, safety and awareness of warfarin therapy according to different geographical regions in Turkey.
背景
在土耳其，不同地区的维生素 K 拮抗剂治疗患者的治疗范围内时间可能不同。
目的
根据土耳其 WARFARIN-TR 研究（土耳其人群中华法林的知晓率、疗效、安全性和治疗范围时间）中不同地理区域的患者，评估治疗范围内时间的百分比、疗效、安全性和对华法林的认识。
研究设计
横断面研究。
方法
WARFARIN-TR 研究纳入了 4987 名使用华法林的患者，于 2014 年 1 月 1 日至 12 月 31 日进行了定期国际标准化比值监测。患者接受了为期 12 个月的随访。样本量计算根据区域人口密度和土耳其统计局数据进行分析。治疗范围内时间根据 F.R. Roosendaal 的算法计算。意识通过基于文献综述开发的简单问题评估患者对华法林的作用和食物-药物相互作用的知识。
结果
在 WARFARIN-TR 研究中，土耳其范围内的治疗范围内时间报告为 49.5%±22.9。不同地区之间的治疗范围内时间存在统计学显著差异（p>0.001）。马尔马拉地区（54.99%±20.91）报告的比例最高，东南部安纳托利亚地区（41.95±24.15）最低（p>0.001）。出血事件最常见于东安纳托利亚（41.6%），而主要出血发生在爱琴海地区（5.11%）和东南部安纳托利亚（5.36%）。不同地区之间的意识存在统计学显著差异（p>0.001）。
结论
根据土耳其不同地理区域，华法林治疗的疗效、安全性和意识存在统计学显著差异。
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