Effect of warfarin anticoagulation therapy on efficacy and prognosis in elderly patients with stable coronary heart disease and non valvular atrial fibrillation / 中国基层医药

ABSTRACT

Objective To investigate the influence of warfarin anticoagulation intensity on curative effect and prognosis in patients with non valvular atrial fibrillation in elderly patients with stable coronary heart disease .Methods From February 2012 to March 2014,96 elderly patients with stable coronary heart disease and non valvular atrial fibrillation in the Second People's Hospital of Yuyao were randomly divided into study group ( low intensity warfarin therapy) and control group(warfarin therapy) according to the digital table,with 48 cases in each group.The patients were followed up for average 2 years after treatment ,the condition of taking drugs ,major secondary end point ,end point and safety were compared between the two groups .Results The INR and warfarin dosage of the study group were lower than those of the control group [(1.71 ±0.38) vs.(2.37 ±0.36),(2.72 ±0.28) mg/d vs.(3.54 ± 0.34)mg/d],the differences were statistically significant (t＝8.736,12.898,all P＜0.05),there were no statistically significant differences in other drugs use between the two groups (χ2＝0.178,0.066,0.344,0.071,0.545,0.042, 0.066,all P＞0.05).There were no statistically significant differences in ischemic stroke and body circulation embolism rate between the two groups (χ2＝0.000,0.211,0.211,0.000,0.000,0.000,0.000,1.011,0.000,all P＞0.05). There were no statistically significant differences in end point of all －cause death or nonfatal myocardial infarction incidence between the two groups (χ2＝1.011,0.000,0.000,0.211,0.000,0.000,0.000,0.211,all P＞0.05). The mild bleeding and total bleeding rate of the study group were lower than those of the control group (2.08% vs. 12.50%,4.16%vs.18.75%),the differences were statistically significant (χ2＝3.852,5.031,all P＜0.05).There was no statistically significant difference in the rate of major bleeding events between the two groups (2.08% vs. 6.25%,χ2＝1.043,P ＞0.05).Conclusion The low intensity and moderate intensity warfarin anticoagulation therapy has similar efficacy for elderly patients with stable coronary heart disease and non valvular atrial fibrillation, but low intensity warfarin anticoagulation therapy is safer .