Earticle

초록

영어

Purpose: Warfarin is the most widely used anticoagulant drug for preventing cardiovascular diseases after ischemic stroke and thromboembolism related to atrial fibrillation, artificial heart valves, deep vein thrombosis, and pulmonary embolism. Warfarin is commonly used in combination with other drugs such as diuretics in order to treat the comorbidity. Although several warfarin-diuretics interactions have been reported, the results are conflicting. Therefore, the initial aim of this study was to identify the effects of diuretics on the warfarin response in patients with atrial fibrillation. Methods: One hundred forty six patients with atrial fibrillation who were on anticoagulation therapy with warfarin and maintained INR levels of 2-3 for three consecutive times were followed up, retrospectively. Stable warfarin doses and INR per stable warfarin dose were compared according to age, gender, comorbidity, and concurrent medication. The stable warfarin dose was defined as the maintenance dose of warfarin of the measured patient whose INR was within the target INR range more than 3 times consecutively. Results: The differences of stable warfarin doses in patients with (3.22±1.21 mg/day) and without (3.58±1.14 mg/day) diuretics were marginally significant (P=0.069). On the other hand, stable warfarin doses were 2.97±1.10 mg/day in patients with thiazide (n=36) and 3.58±1.14 mg/day in patients without diuretics (n=82), which was statistically significant (p=0.009). INR values per stable warfarin dose in patients with diuretics and thiazide were 0.84±0.31 and 0.90±0.34, respectively, which were statistically different from those without diuretics (0.72±0.21, P=0.010 and P=0.006, respectively). Age, gender, and concurrent use of thiazide diuretics were found to have significant influence on the warfarin response from multivariate analysis. Conclusion: Our study showed that the concurrent use of thiazide diuretics could increase the response of warfarin in patient with atrial fibrillation. Therefore, clinicians should be aware that warfarin dose needs to be adjusted when it is used with thiazide diuretics concomitantly.

목차

Abstract
 연구 방법
  대상환자
  평가항목
  자료수집
  자료 분석
  통계 분석
 연구 결과
 고찰
 결론
 참고문헌

키워드

저자

• 박희주 [ Hee Joo Park | 이화여자대학교 임상보건과학대학원, 가톨릭대학교 서울성모병원 약제부 ]
• 나현오 [ Hyen-Oh La | 가톨릭대학교 서울성모병원 약제부, 가톨릭대학교 의과대학 약리학교실 ]
• 곽혜선 [ Hye Sun Gwak | 이화여자대학교 임상보건과학대학원, 이화여자대학교 약학대학/생명약학부 ] Correspondence to

참고문헌

발행기관

간행물

표지보기 관심저널 등록

• 간행물명

  한국임상약학회지 [Korean Journal of Clinical Pharmacy]

• 간기

  계간

• pISSN

  1226-6051

• 수록기간

  1991~2026

• 등재여부

  KCI 등재

• 십진분류

  KDC 518 DDC 615