Publication

Abstract : Aim: To compare and evaluate the effectiveness of warfarin and acenocoumarol in atrial fibrillation patients. Methods: It was a prospective observational study for a period of 1 year. The effectiveness was determined by comparing individual mean Time in therapeutic range (TTR) calculated using Fraction of INR in range method as well as by evaluating stroke risk using CHA2DS2VASc scores. The safety of the drug therapy was assessed from the ADR occurred after the drug administration. The data was analyzed using statistical software (version 20). Result: A total of 218 patients were selected for the study. The mean age of patients treated with acenocoumarol was 57.01±13.07 years and that of patients treated with warfarin was 67.18±12.24 years respectively. Mean TTR was found to be 56.54% ± 19.67 vs 50.69% ± 23.57 for acenocoumarol and warfarin respectively (p value <0.05). After the drug initiation, 12 patients experienced stroke episodes in acenocoumarol group while 24 patients experienced stroke in warfarin treated group (p value <0.05). A total of 463 ADRs were observed during the study period, of which 174 belong to acenocoumarol treated patients and 289 to warfarin group. Among these, bleeding (127 patients) was the main ADR (55 vs 72) with p value of 0.001. Conclusion: This study concluded that acenocoumarol is a better oral anticoagulant compared to warfarin while considering various factors like mean TTRs, ADRs observed, stroke incidence and QOL of patients.