Age- and weight-adjusted warfarin initiation nomogram for ischaemic stroke patients
European Journal of Neurology, 06/21/2012
Clinical Article
Yoo SH et al. - Weight-adjusted warfarin initiation nomogram (AW-WIN) reduces the time to target international normalized ratios (INRs) and the risk of excessive anticoagulation. AW-WIN may be an efficient and safe method of anticoagulation during the acute phase of ischaemic stroke.
Methods- Age- and weight-adjusted warfarin initiation nomogram was administered to 104 acute ischaemic stroke patients between January 2008 and February 2009.
- A historical control group (PDWD) of 96 patients was selected from comparable patients who were discharged with warfarin during the previous year.
- Time-to-therapeutic international normalized ratios (INRs) and the incidence of excessive anticoagulation were compared in the AW-WIN and PDWD groups.
- The general characteristics, risk factors, and stroke mechanism of the AW-WIN and PDWD groups did not differ significantly.
- The mean time to INR ≥ 2.0 was significantly shorter in the AW-WIN than in the PDWD group (4.9 ± 0.7 vs. 6.2 ± 0.8 days, P = 0.0008).
- After adjustment for potential confounding variables, the AW-WIN group reached target INR faster than the PDWD group (hazard ratio, 1.76; 95% confidence interval, 1.26–2.45; P = 0.001).
- The time-to-therapeutic INR ≥1.7 was shorter (P = 0.0002), the proportion of patients with therapeutic INR (2–3) at 5 days was higher (P = 0.002), and the rate of excessive anticoagulation of ≥3.5 INR during hospitalization was lower (P = 0.024) in the AW-WIN than in the PDWD group.
