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dc.contributor.authorNelson, Winnie W
dc.contributor.authorWang, Li
dc.contributor.authorBaşer, Onur
dc.contributor.authorDamaraju, Chandrasekharrao, V
dc.contributor.authorSchein, Jeffrey R
dc.date.accessioned2019-02-28T13:04:26Z
dc.date.accessioned2019-02-28T11:08:12Z
dc.date.available2019-02-28T13:04:26Z
dc.date.available2019-02-28T11:08:12Z
dc.date.issued2015en_US
dc.identifier.citationNelson, W. W., Wang, L., Baser, O., Damaraju, C. V., & Schein, J. R. (February 01, 2015). Out-of-range INR values and outcomes among new warfarin patients with non-valvular atrial fibrillation. International Journal of Clinical Pharmacy, 37, 1, 53-59.en_US
dc.identifier.issn2210-7703
dc.identifier.urihttp://dx.doi.org/10.1007/s11096-014-0038-3
dc.identifier.urihttps://hdl.handle.net/20.500.11779/610
dc.descriptionOnur Başer (MEF Author)en_US
dc.description.abstractBackground Although efficacious in stroke prevention in non-valvular atrial fibrillation, many warfarin patients are sub-optimally managed. Objective To evaluate the association of international normalized ratio control and clinical outcomes among new warfarin patients with non-valvular atrial fibrillation. Setting Adult non-valvular atrial fibrillation patients (a parts per thousand yen18 years) initiating warfarin treatment were selected from the US Veterans Health Administration dataset between 10/2007 and 9/2012. Method Valid international normalized ratio values were examined from the warfarin initiation date through the earlier of the first clinical outcome, end of warfarin exposure or death. Each patient contributed multiple in-range and out-of-range time periods. Main outcome measure The relative risk ratios of clinical outcomes associated with international normalized ratio control were estimated. Results 34,346 patients were included for analysis. During the warfarin exposure period, the incidence of events per 100 person-years was highest when patients had international normalized ratio < 2:13.66 for acute coronary syndrome; 10.30 for ischemic stroke; 2.93 for transient ischemic attack; 1.81 for systemic embolism; and 4.55 for major bleeding. Poisson regression confirmed that during periods with international normalized ratio < 2, patients were at increased risk of developing acute coronary syndrome (relative risk ratio: 7.9; 95 % confidence interval 6.9-9.1), ischemic stroke (relative risk ratio: 7.6; 95 % confidence interval 6.5-8.9), transient ischemic attack (relative risk ratio: 8.2; 95 % confidence interval 6.1-11.2), systemic embolism (relative risk ratio: 6.3; 95 % confidence interval 4.4-8.9) and major bleeding (relative risk ratio: 2.6; 95 % confidence interval 2.2-3.0). During time periods with international normalized ratio > 3, patients had significantly increased risk of major bleeding (relative risk ratio: 1.5; 95 % confidence interval 1.2-2.0). Conclusion In a Veterans Health Administration non-valvular atrial fibrillation population, exposure to out-of-range international normalized ratio values was associated with significantly increased risk of adverse clinical outcomes.en_US
dc.language.isoengen_US
dc.relation.ispartofInternational Journal Of Clinical Pharmacyen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAtrial fibrillationen_US
dc.subjectClinical outcomesen_US
dc.subjectInternational normalized ratioen_US
dc.subjectUSAen_US
dc.subjectUS veteransen_US
dc.subjectWarfarinen_US
dc.titleOut-of-range INR values and outcomes among new warfarin patients with non-valvular atrial fibrillationen_US
dc.typearticleen_US
dc.departmentİİSBF, Ekonomi Bölümüen_US
dc.identifier.volume37en_US
dc.identifier.issue1en_US
dc.identifier.startpage53en_US
dc.identifier.endpage59en_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.description.wosidWOS:000349016600011en_US
dc.description.scopusid2-s2.0-84925500632en_US
dc.contributor.institutionauthorBaşer, Onur
dc.description.pubmedidPMID: 25428444en_US
dc.description.woscitationindexScience Citation Index Expandeden_US
dc.description.qualityQ4en_US
dc.description.WoSDocumentTypeArticleen_US
dc.description.WoSInternationalCollaborationUluslararası işbirliği ile yapılan - EVETen_US
dc.description.WoSPublishedMonthŞubaten_US
dc.description.WoSIndexDate2015en_US
dc.description.WoSYOKperiodYÖK - 2014-15en_US
dc.identifier.doi10.1007/s11096-014-0038-3en_US


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