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- MakaleYalnız künye2014Scopus SJRQ2Relationship between platelet indices and international normalized ratio in patients with non-valvular atrial fibrillation
Arik, Osman Ziya; Özkan, Bugra; Kutlu, Rasim; Karal, Huseyin; Sahin, Durmus Yildiray; Kaypakli, Onur; Özel, Deniz; Çayil, Murat
Atrial fibrillation (AF) is the most common sustained arrhythmia and associated with adverse outcomes and increased risk for thromboembolic events. Warfarin is still the most extensively prescribed oral anticoagulant in AF to prevent ischemic complications. We aimed to determine the differences at platelet indices with warfarin usage layered by International Normalized Ratio (INR). A total of 250 patients with permanent non-valvular AF (mean age 70.2 +/- 9.1; 153 female) were divided into two groups. Group 1 included 125 patients whose INR is between 2.0 and 3.0 (called as effective'') and Group 2 included 125 patients whose INR is <2.0 (called as ineffective''). Also 123 age- and sex-matched individuals in sinus rhythm enrolled as control group (Group 3). After physical and echocardiographic examination, complete blood counts and INR were studied. There was no statistically significant difference in age, sex, co-morbidities and medications, also hemoglobin, white blood cell and platelet counts among the groups. The CHA(2)DS(2)-VASc scores were similar between Groups 1 and 2. The mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) were significantly higher in Group 2 than Groups 1 and 3 and similar between Groups 1 and 3. MPV was positively correlated with PDW and PCT and also inversely correlated with INR value and platelet count. On multivariate logistic regression analysis, MPV, PDW and PCT were independent predictors of ineffectiveness of INR. The results of this study showed that MPV, PDW and PCT are increased in patients with non-valvular AF without effective warfarin treatment. Warfarin usage adjusted by INR is associated with lower values of these platelet indices, even lower as the values of subjects in sinus rhythm. MPV, PDW and PCT are independent predictors of INR ineffectiveness and seem to be useful parameters for monitoring the effectiveness of warfarin treatment.
AtıfWoS15OpenAlex18
İncele - MakaleYalnız künye2012Scopus SJRQ2Aspirin, clopidogrel, and warfarin use and outcomes in a cohort of 580 patients discharged after hospitalization for decompensated heart failure
Kozdaǧ, Güliz; Yaymaci, Mehmet; Ertaş, Gökhan; Çelikyurt, Umut; Şahin, Tayfun; Kiliç, Teoman; Ural, Dilek
The benefits of taking of aspirin, clopidogrel, and warfarin in relation to cardiovascular mortality and re-hospitalization in chronic heart failure (HF) patients have been called into question. We examined the outcomes (cardiac mortality and/or HF re-hospitalization) in patients discharged from our hospital between January 2003 and July 2009 after hospitalization for chronic decompensated HF. Of 580 HF patients (mean age, 63 ± 13 years; mean ejection fraction, 26 ± 9%, 63% with coronary disease and 37% without coronary disease), 207 patients (36%) died due to cardiovascular reasons, and 313 (54%) required HF re-hospitalization for decompensated HF during a 39 ± 14 month follow-up period. 101 (17%) patients were taking clopidogrel during enrollment in the study. When comparing patients who were on clopidogrel treatment with those who were not, clopidogrel was found to have a beneficial effect on cardiac mortality (27 vs. 38%, P = 0.04). In conclusion, in this observational prospective study, patients who used clopidogrel showed decreased cardiac mortality [HR, 0.566 (95% CI 0.332-0.964), P = 0.036] compared to patients who did not take clopidogrel. Clopidogrel had a beneficial effect on the survival of chronic HF patients in the long term.
AtıfScopus10OpenAlex10
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