The Relationship Between Clinical Factors And Warfarin Stable Does In Patients With Non-valvular Atrial Fibrillation

ObjectiveThrough analyzing the clinical factors in NVAF patients,aim to find the relationship between various clinical factors and warfarin stable dose.So that,we can help to guide the initial dose of warfarin in patients with NVAF,thus reducing the INR monitoring,making the patients to have warfarin stable doses in a shorter time.MethodsCollect The NVAF patients who received oral warfarin anticoagulation from January to December 2017 in the department of cardiovascular medicine of Zhongda Hospital.Record their information,including:1)relevant demographic information:gender,age,height,weight,race and ethnicity;2)previous disease:chronic heart disease,chronic digestive disease,chronic respiratory disease,connective tissue disease,hypertension,diabetes,chronic kidney disease,tumor and cerebral infarction;3)personal history:smoking,drinking and surgical history;4)clinical factors:TSH,FT3,FT4,ALT,AST,TBIL,SCr,BUN,TG,TC,EF,LA,RA,LV,RV;5)medication status:amiodarone,antiplatelet drugs,digoxin,diuretics,?-blocker,statins,CCB,ACEI,ARB;6)the dose of warfarin when INR is stable.Finally,SPSS 19.0.0software was used for statistical analysis.ResultsA total of 341 patients are included,all of them are han Chinese,171 patients are male and 170 patients are female.The results indicat that there are significant differences in age and weight between the warfarin groups with different stable doses,with P values of 0.010 and 0.037,respectively.Age is correlated with the average daily stable dose of warfarin,with r values of-0.213 and P values is less than 0.05.Hypertension,chronic kidney disease,antiplatelet drugs,diuretics,and?-blocker are the effective factors of warfarin stable dose(P<0.05).CCr,SCr,BUN,TG,TC are correlated with warfarin daily stable dose.CCr,TG and TC are positively correlated with warfarin daily stable dose,with P values of 0.009,0.048 and 0.003,and r values of 0.141,0.109 and 0.165,respectively.SCr,BUN and average daily stable dose of warfarin are negatively correlated,with P value of 0.001 and r value of-0.182 and-0.178,respectively.The prediction model of warfarin stable dose in this study is obtained through regression analysis:warfarin daily stable dose(mg)=4.029-0.021*age(years)-0.486*chronic renal history+0.279*hypertension-0.251*?-blocker.(chronic kidney disease:YES=1,NO=0,hypertension:YES=1,NO=0,?-blocker:YES=1,NO=0.)Conclusions1.Age,weight,hypertension,chronic kidney disease,antiplatelet drugs,diuretics,?-blocker,serum creatinine value,endogenous creatinine clearance,blood urea nitrogen,total triglycerides,and total cholesterol are the effective factors of warfarin stable dose.2.Warfarin stable dose prediction model:warfarin daily stable dose(mg)=4.029-0.021*age(years)-0.486*chronic renal history+0.279*hypertension-0.251*?-blocker.The R~2 value is 0.143.This model can explain the individual difference of warfarin stable dose of 14.3%.