[Risk Factors of Recurrent Bleedings at Therapeutic International Normalized Ratio in Patients on Long-Term Warfarin Therapy]

Kardiologiia. 2016 Feb;56(2):40-46. doi: 10.18565/cardio.2016.2.40-46.
[Article in Russian]

Abstract

Aim: to investigate parameters of fibrinolysis in patients on long-term warfarin (W) therapy, and assess their relation to the risk of recurrent bleeding occurring at therapeutic international normalized ratio (INR).

Materials and methods: Our prospective study involved 78 W-naive patients (40 men, age 64.3+/-12.2 years). Follow up period was 5.6+/-3.4 months. INR was measured monthly; determination of coagulation parameters (D-dimer, fibrinogen, complex plasmin-2-antiplasmin [PAP] and thrombin-activatable fibrinolysis inhibitor [TAFI] was performed before and after at least 3 months of W therapy.

Results: During follow-up bleedings occurred in 47 (60.3%) patients, 26 patients (33.3%) had recurrent bleedings at therapeutic INR and 21 patients (26.9%) had single bleeding. Mean time in therapeutic range (TTR) was >70.

MeSH terms

  • Anticoagulants* / administration & dosage
  • Anticoagulants* / adverse effects
  • Anticoagulants* / therapeutic use
  • Blood Coagulation
  • Fibrin Fibrinogen Degradation Products
  • Fibrinolysin
  • Hemorrhage*
  • Humans
  • International Normalized Ratio
  • Male
  • Prospective Studies
  • Recurrence
  • Risk Factors
  • Warfarin* / administration & dosage
  • Warfarin* / adverse effects
  • Warfarin* / therapeutic use
  • alpha-2-Antiplasmin

Substances

  • Anticoagulants
  • Fibrin Fibrinogen Degradation Products
  • alpha-2-Antiplasmin
  • fibrin fragment D
  • plasmin-plasmin inhibitor complex
  • Warfarin
  • Fibrinolysin