{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T04:55:10Z","timestamp":1761540910079},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2009,2,3]],"date-time":"2009-02-03T00:00:00Z","timestamp":1233619200000},"content-version":"vor","delay-in-days":2835,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2001,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Background: Despite reported evidence of the vital importance of appropriate anticoagulation in patients with chronic atrial fibrillation for stroke prevention, this treatment modality still lags behind optimal requirements.<\/jats:p><jats:p>Hypothesis: Our objectives were to evaluate various doctor\u2010or patient\u2010related factors that influence quality of control and to assess the adequacy of anticoagulation provided by physicians in the community.<\/jats:p><jats:p>Methods: In a retrospective study, International Normalized Ratio (INR) values obtained immediately on admission to hospital were considered representative of previous long\u2010term control.<\/jats:p><jats:p>Results: Only 42% of the relevant 385 patient population fell within the protective anticoagulation range of INR 1.91\u20104.1. The respective figures for patients with poor (INR &lt; 1.5) or suboptimal (INR 1.51\u20101.9) control, as well as those whose INR values risked bleeding (INR &gt; 4.1), were 28.3, 14.1, and 15.6%. Patient involvement in treatment positively influenced quality of control. By contrast, age 70\u201380 years or absence of congestive heart failure negatively affected quality of anticoagulation [p = 0.07, odds ratio (OR), 1.7 (95% confidence interval, 0.94\u20133.08), p = 0.014, OR, 2.06 (95% confidence interval, 1.15\u20133.7) respectively]. The percentage of patients admitted with stroke who had been adequately anticoagulated was significantly lower than that of patients who had no stroke (21 vs. 44.4%). Adequacy of anticoagulation in patients with cardiac prosthetic valves was superior compared with the rest of the patient population (56.7 vs. 42% with optimal, and only 14.5 vs. 28.3% with poor anticoagulation, respectively), indicating that under the same conditions a better quality of treatment could be achieved.<\/jats:p><jats:p>Conclusions: Adequacy of anticoagulation in patients with atrial fibrillation lags behind actual recommendations. Better control is required and achievable.<\/jats:p>","DOI":"10.1002\/clc.4960240507","type":"journal-article","created":{"date-parts":[[2009,2,3]],"date-time":"2009-02-03T23:15:26Z","timestamp":1233702926000},"page":"380-384","source":"Crossref","is-referenced-by-count":4,"title":["Adequacy of anticoagulation in patients with atrial fibrillation: Effect of various parameters"],"prefix":"10.1002","volume":"24","author":[{"given":"Natan","family":"Cohen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorit","family":"Almoznino\u2010Sarafian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irena","family":"Alon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oleg","family":"Gorelik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margarita","family":"Koopfer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shulamit","family":"Chachashvily","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Shteinshnaider","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vladimir","family":"Litvinjuk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Modai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,2,3]]},"reference":[{"key":"e_1_2_1_1_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.114.5_Supplement.579S"},{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-131-7-199910050-00003"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-131-9-199911020-00010"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1994.00420130036007"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.97.13.1231"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02598984"},{"key":"e_1_2_1_7_2","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1001\/archinte.1997.00440250097011","article-title":"Is warfarin underused in the treatment of elderly persons with atrial fibrillation?","volume":"157","author":"Whittle J","year":"1997","journal-title":"Arch Intern Med"},{"key":"e_1_2_1_8_2","doi-asserted-by":"crossref","first-page":"2311","DOI":"10.1001\/archinte.1996.00440190053006","article-title":"Status of antithrombotic therapy for patients with atrial fibrillation in university hospitals","volume":"156","author":"Albers GW","year":"1996","journal-title":"Arch Intern Med"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.314.7093.1529"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.71.1.92"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.48.6.1598"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)00326-4"},{"key":"e_1_2_1_13_2","first-page":"152","article-title":"Comparison of anticoagulant control among patients attending general practice and a hospital anticoagulant clinic","volume":"43","author":"Pell JP","year":"1993","journal-title":"Br J Gen Pratt"},{"key":"e_1_2_1_14_2","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1001\/archinte.1997.00440300080006","article-title":"Atrial fibrillation and stroke prevention with warfarin in the long\u2010term care setting","volume":"157","author":"Gurwitz JH","year":"1997","journal-title":"Arch Intern Med"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.158.15.1641"},{"key":"e_1_2_1_16_2","doi-asserted-by":"crossref","unstructured":"PetersenP GodtfredsenJ BoysenG AndersenED AndersenB:Placebo\u2010controlled randomised trial of warfarin and aspirin for prevention of thromboembolic complications in chronic atrial fibrillation. 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