INTRODUCTION: Warfarin is a drug used for anticoagulation in diseases, especially atrial fibrillation (AF). The effectiveness of warfarin is monitored by the International Normalized Ratio (INR) and should be kept between 2.0 and 3.0 in the AF clinic. This drug the significant variability in dose response and the narrow therapeutic index among individuals. However, the effective INR level may not be achieved due to some reasons, or the time to achieve the effective INR level may lengthen. Our aim in this study is to investigate whether there is a difference in terms of dose and duration in achieving the effective INR level by the warfarin treatment due to the coexistence of AF and stroke between patients with and without diabetes mellitus (DM). METHODS: A total of 70 patients whose warfarin treatment was initiated due to non-valvular AF and who were diagnosed with acute ischemic stroke were included in the study, 30 of these patients were DM patients and 40 were non-DM patients. The total dose and time values at achieving the effective INR level after the initiation of warfarin treatment according to the clinical protocol during follow-ups in hospital were statistically compared between the two groups. RESULTS: In the study, it was found that the total warfarin dose was significantly higher in the DM group compared to the non DM group (p<0.05). It was detected that the time to achieve the effective INR level was also significantly longer in the DM group than in the non-DM group (p<0.05). CONCLUSION: In the presence of DM diagnosis, the higher dose warfarin and longer follow-up are required to achieve effective INR levels in stroke patients whose warfarin treatment was initiated due to non-valvular AF. Copyright:
INTRODUCTION: Warfarin is a drug used for anticoagulation in diseases, especially atrial fibrillation (AF). The effectiveness of warfarin is monitored by the International Normalized Ratio (INR) and should be kept between 2.0 and 3.0 in the AF clinic. This drug the significant variability in dose response and the narrow therapeutic index among individuals. However, the effective INR level may not be achieved due to some reasons, or the time to achieve the effective INR level may lengthen. Our aim in this study is to investigate whether there is a difference in terms of dose and duration in achieving the effective INR level by the warfarin treatment due to the coexistence of AF and stroke between patients with and without diabetes mellitus (DM). METHODS: A total of 70 patients whose warfarin treatment was initiated due to non-valvular AF and who were diagnosed with acute ischemic stroke were included in the study, 30 of these patients were DM patients and 40 were non-DM patients. The total dose and time values at achieving the effective INR level after the initiation of warfarin treatment according to the clinical protocol during follow-ups in hospital were statistically compared between the two groups. RESULTS: In the study, it was found that the total warfarin dose was significantly higher in the DM group compared to the non DM group (p<0.05). It was detected that the time to achieve the effective INR level was also significantly longer in the DM group than in the non-DM group (p<0.05). CONCLUSION: In the presence of DM diagnosis, the higher dose warfarin and longer follow-up are required to achieve effective INR levels in stroke patients whose warfarin treatment was initiated due to non-valvular AF. Copyright:
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