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https://hdl.handle.net/2440/128417
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dc.contributor.author | Nguyen, M.T. | - |
dc.contributor.author | Gallagher, C. | - |
dc.contributor.author | Pitman, B.M. | - |
dc.contributor.author | Emami, M. | - |
dc.contributor.author | Kadhim, K. | - |
dc.contributor.author | Hendriks, J.M. | - |
dc.contributor.author | Middeldorp, M.E. | - |
dc.contributor.author | Roberts-Thomson, K.C. | - |
dc.contributor.author | Mahajan, R. | - |
dc.contributor.author | Lau, D.H. | - |
dc.contributor.author | Sanders, P. | - |
dc.contributor.author | Wong, C.X. | - |
dc.date.issued | 2019 | - |
dc.identifier.citation | Heart Lung and Circulation, 2019; 29(8):1122-1128 | - |
dc.identifier.issn | 1443-9506 | - |
dc.identifier.issn | 1444-2892 | - |
dc.identifier.uri | http://hdl.handle.net/2440/128417 | - |
dc.description.abstract | BACKGROUND: Studies have shown that suboptimal anticoagulation quality, as measured by time in therapeutic range (TTR), affects a significant percentage of patients with atrial fibrillation (AF). However, TTR has not been previously characterised in Indigenous Australians who experience a greater burden of AF and stroke. METHOD: Indigenous and non-Indigenous Australians with AF on warfarin anticoagulation therapy were identified from a large tertiary referral centre between 1999 and 2012. Time in therapeutic range was calculated as a proportion of daily international normalised ratio (INR) values between 2 and 3 for non-valvular AF and 2.5 to 3.5 for valvular AF. INR values between tests were imputed using the Rosendaal technique. Linear regression models were employed to characterise predictors of TTR. RESULTS: Five hundred and twelve (512) patients with AF on warfarin were included (88 Indigenous and 424 non-Indigenous). Despite younger age (51±13 vs 71±12 years, p<0.001), Indigenous Australians had greater valvular heart disease, diabetes, and alcohol excess compared to non-Indigenous Australians (p<0.05 for all). Time in therapeutic range was significantly lower in Indigenous compared to non-Indigenous Australians (40±29 vs 50±31%, p=0.006). Univariate predictors of poorer TTR included Indigenous ethnicity, younger age, diuretic use, and comorbidities, such as valvular heart disease, heart failure and chronic obstructive pulmonary disease (p<0.05 for all). Valvular heart disease remained a significant predictor of poorer TTR in multivariate analyses (p=0.004). CONCLUSION: Indigenous Australians experience particularly poor warfarin anticoagulation quality. Our data also suggest that many non-Indigenous Australians spend suboptimal time in therapeutic range. These findings reinforce the importance of monitoring warfarin anticoagulation quality to minimise stroke risk. | - |
dc.description.statementofresponsibility | Mau T. Nguyen, Celine Gallagher, Bradley M. Pitman, Mehrdad Emami, Kadhim Kadhim, Jeroen M. Hendriks … et al. | - |
dc.language.iso | en | - |
dc.publisher | Elsevier | - |
dc.rights | © 2019 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).Published by Elsevier B.V. All rights reserved. | - |
dc.source.uri | http://dx.doi.org/10.1016/j.hlc.2019.11.006 | - |
dc.subject | Anticoagulation | - |
dc.subject | Atrial fibrillation | - |
dc.subject | Indigenous | - |
dc.subject | Stroke | - |
dc.subject | Warfarin | - |
dc.title | Quality of warfarin anticoagulation in indigenous and non-indigenous Australians with atrial fibrillation | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1016/j.hlc.2019.11.006 | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Gallagher, C. [0000-0002-5114-400X] | - |
dc.identifier.orcid | Pitman, B.M. [0000-0001-6610-3473] | - |
dc.identifier.orcid | Emami, M. [0000-0003-2093-6909] | - |
dc.identifier.orcid | Kadhim, K. [0000-0002-8928-0402] | - |
dc.identifier.orcid | Hendriks, J.M. [0000-0003-4326-9256] | - |
dc.identifier.orcid | Middeldorp, M.E. [0000-0002-4106-9771] | - |
dc.identifier.orcid | Mahajan, R. [0000-0003-3375-5568] | - |
dc.identifier.orcid | Lau, D.H. [0000-0001-7753-1318] | - |
dc.identifier.orcid | Sanders, P. [0000-0003-3803-8429] | - |
dc.identifier.orcid | Wong, C.X. [0000-0002-1913-6675] | - |
Appears in Collections: | Aurora harvest 8 Medicine publications |
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