Earticle

초록

영어

Objective: Direct current cardioversion for atrial fibrillation could be associated with the risk of thromboembolic events. Anticoagulation therapy with warfarin (INR 2.0-3.0) is recommended 3 weeks before and 4 weeks after cardioversion to reduce the risk of thromboembolism. This study evaluated warfarin therapy in pharmacist-managed anticoagulant services (ACS). Methods: This retrospective study was performed in 106 patients with atrial fibrillation from 2012 to 2013. The primary efficacy endpoint was the composite of stroke, transient ischemic attack, myocardial infarction, and cardiovascular death. The primary safety measure was major bleeding. To evaluate the peri-procedural effects of warfarin treatment, we studied whether target INR was maintained, as well as the maintenance period of the therapeutic range. Quality of treatment was measured by time in therapeutic range (TTR) by using the Rosendaal method. Results: There were no thromboembolic events, but TEE examination at time of cardioversion showed a left atrial thrombus in three patients (2.8%). Bleeding complications after cardioversion occurred in 2 patients (1.9%). The average INR value at the time of cardioversion was 2.59±0.8, and was within the therapeutic range in 83 patients (78%). Analysis of the patients in whom the value was within the therapeutic range twice consecutively showed that the ratio of TTR was 80% and the therapeutic range was maintained in 67 patients (63%) for an average of 4.90 weeks prior to cardioversion. Similarly, 76 patients (72%) had a stable INR within the therapeutic range for an average of 5.70 weeks and a mean TTR of 83%. Conclusion: Pharmacists significantly contributed to appropriate warfarin treatment with close monitoring during cardioversion. Likewise, active pharmacist monitoring and systemic management should be considered to reduce thromboembolism and bleeding complications in the peri-cardioversion period.

목차

ABSTRACT
 연구 방법
  연구대상
  자료수집
  분석방법
 연구 결과
  인구학적 특성
  Warfarin을 통한 항응고치료 평가
  심율동전환 시행 전후 혈전색전증, 출혈부작용 발생빈도
  ACS 상담기록 분석
 고찰 및 결론
 참고문헌

키워드

저자

• 문정연 [ Jung-Yeon Moon | 서울대학교병원 약제부 ] Corresponding author
• 김보람 [ Bo-Ram Kim | 서울대학교병원 약제부 ]
• 조은정 [ Eun-Jung Jo | 서울대학교병원 약제부 ]
• 조윤숙 [ Yoon-Sook Cho | 서울대학교병원 약제부 ]
• 한현주 [ Hyun-Joo Han | 서울대학교병원 약제부 ]
• 최의근 [ Eue-Keun Choi | 서울대학교병원 순환기내과 ]

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