Safety and efficacy of warfarin in treating atrial fibrillation / Mohamad Amal Shamsul Jasmi

Background: Warfarin is an oral anticoagulant that inhibits the synthesis of vitamin K in the body. It mainly acts as the prophylaxis of stroke for atrial fibrillation patients. This study aimed to evaluate the safety and efficacy of warfarin in the first six months of treatment by evaluating Time in Therapeutic Range of patients and evaluating CHADS2 V ASc and HASBLED score and their relationship to stroke and bleeding incidences. Results and Discussions: A total of 167 data of patients were collected retrospectively. In 157 patients, TTR were found to be outside its intended range (>75%) with 45 of them experienced bleeding in the first six months of warfarin treatment. While only two patients out of ten with TTR >75% experienced bleeding. None of these patients experienced stroke. Bleeding incidences were found to increase with increasing HASBLED score with bleeding occurring at score more than 3. There were a total of 47 patients experiencing bleeding incidences with 42 of them being minor bleeding. The highest identified occurring reason of INR readings out of range was found to be patient non-compliance which was seen in 46 patients. However, the cause was unidentified in 64 patients. Conclusion: There would be a problem maintaining TTR at >75% for the first 6 months. However for TTR less than <75%, bleeding incidence was found to be low which affects only 29% of them. No incidence of stroke was recorded. This shows that warfarin could be both effective and safe in the prevention of stroke in AF patients providing that proper management guidelines were followed.