Abstract:

AIM: To explore the effects of different intensity of warfarin on patients with coronary atherosclerotic heart disease complicated with atrial fibrillation.  METHODS: One hundred and seven cases of coronary heart disease complicated with atrial fibrillation patients in our hospital were selected and were randomly divided into experimental group (n=54) and control group (n=53) by random number table. The experimental group (low intensity) received initial amount of warfarin for 1.25 mg/d, and NR monitoring 24 h after treatment, if INR <1.4, 3-5 mg/d increased by 0.5-1.0 mg/d, monitoring one time per week, INR maintained within 1.4-2.0. INR of the control group (medium intensity) maintained within 2.0-2.6. One month monitoring after INR stabilized. All patients were treated for about 4 weeks, and warfarin was maintained at a dose of 1.25-7.5 mg/d. The primary and secondary end points and bleeding events were observed and compared after 2 years of treatment. RESULTS:The INR of the experimental group and the control group were 1.71±0.38, 2.36±0.35, respectively. The ratio of total bleeding event of the experimental group and the control group was 22.2% and 41.5%, respectively. Those of the experimental group were lower than those of the control group, and the difference was all statistically significant (P<0.05). CONCLUSION: The efficacy of low-intensity warfarin in the treatment of coronary atherosclerotic heart disease complicated with atrial fibrillation is comparable to that of moderate-intensity warfarin therapy, but low-intensity warfarin shows better saftey.

Key words: warfarin, coronary heart disease, atrial fibrillation, curative effect