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Despite evidence linking Time in Therapeutic Range (TTR) to patient outcomes, its use in clinical practice is not widespread. This prospective study explores the impact of a TTR-INR guided Warfarin adjustment protocol on TTR in AF patients. Conducted at the Warfarin clinic of King Chulalongkorn Memorial Hospital. TTR was calculated using the Rosendaal linear interpolation method at baseline, and then at 6 and 12\u00a0months post-protocol implementation. The primary outcome was the improvement in TTR following the protocol\u2019s implementation. The study analyzed 57 patients, with a mean age of 72\u00a0years and an even gender distribution. At baseline, 53% of patients had a TTR of less than 65%. However, TTR significantly improved from 65% at baseline to 80% after 12\u00a0months of protocol implementation (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Furthermore, there was a significant increase in the proportion of patients with a TTR of 65% or more, from 47 to 88% (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). During the follow-up period in the first 12\u00a0months, three patients died, but no ischemic or major bleeding events occurred. The significant improvement in TTR after 12\u00a0months of protocol implementation suggests that this strategy could provide additional value in improving TTR and outcomes in AF patients receiving Warfarin.<\/jats:p>","DOI":"10.1038\/s41598-024-61664-5","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T23:01:46Z","timestamp":1716332506000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Utility of TTR-INR guided warfarin adjustment protocol to improve time in therapeutic range in patients with atrial fibrillation receiving warfarin"],"prefix":"10.1038","volume":"14","author":[{"given":"Paisit","family":"Kosum","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noppachai","family":"Siranart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunathip","family":"Nissaipan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wattakorn","family":"Laohapiboolrattana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walit","family":"Sowalertrat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanittha","family":"Triamamornwooth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rawiwan","family":"Arunphan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Apiradee","family":"Sriyom","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3661-1490","authenticated-orcid":false,"given":"Voravut","family":"Rungpradubvong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,5,22]]},"reference":[{"key":"61664_CR1","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1056\/NEJM199809033391003","volume":"339","author":"M Haissaguerre","year":"1998","unstructured":"Haissaguerre, M. et al. 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