Risks and Benefits of Combined Use of Bucolome and Warfarin in Anticoagulation Therapy

• Hatakeyama Yuko

  Department of Cardio-Angiology, Kitasato University School of Medicine

• Niwano Shinichi

  Department of Cardio-Angiology, Kitasato University School of Medicine

• Niwano Hiroe

  Department of Cardio-Angiology, Kitasato University School of Medicine

• Kosukegawa Tomoko

  Department of Cardio-Angiology, Kitasato University School of Medicine

• Izumi Tohru

  Department of Cardio-Angiology, Kitasato University School of Medicine

抄録

Although bucolome has been used empirically to enhance and stabilize warfarin action in some institutes, the clinical risks and benefits of this combination are unclear. In the present study, warfarin monotherapy (WM) and bucolome combination (BC) therapy were compared in anticoagulation therapy.<br>One hundred and ninety-five patients indicated for anticoagulation therapy were randomly assigned to WM (n = 98) or BC (bucolome 300 mg/day, n = 97). The dosage of warfarin was optimized in each patient to maintain the international normalized ratio (INR) level in the appropriate zone, ie, 1.6-2.6 for lower risk and 2.0-3.0 for higher risk patients. The clinical characteristics, clinical events, and time in therapeutic range (TTR) were evaluated and compared between the two groups. TTR was calculated using Rosendaal’s linear interpolation method.<br>The optimal dosage of warfarin was 3.3 ± 1.0 mg/day in WM and 1.4 ± 0.5 mg/day in BC (P < 0.001). During the observation period of 18 ± 6 months, no serious complication was observed and INR was measured 11 ± 3 times in each case. TTR was 0.61 ± 0.13 in WM and 0.62 ± 0.14 in BC (NS), but TTR in the WM subgroup with warfarin > 3 mg (0.58 ± 0.13) was lower than in the WM subgroup with warfarin ≤ 3 mg (0.64 ± 0.13, P = 0.026) and BC (P = 0.042).<br>BC reduced the optimal dosage of warfarin without increasing clinical events. There was no significant difference in TTR between WM and BC, but BC may have benefits in selected cases, such as warfarin resistance.

収録刊行物

• International Heart Journal

  International Heart Journal 51 (6), 399-403, 2010

  一般社団法人 インターナショナル・ハート・ジャーナル刊行会

キーワード

• Anticoagulation
• Warfarin
• Bucolome
• TTR

詳細情報

• CRID: 1390001205224299008
• NII論文ID: 130000410624
• DOI: 10.1536/ihj.51.399
• ISSN: 13493299
• ISSN: 13492365
• Web Site: http://www.jstage.jst.go.jp/article/ihj/51/6/51_6_399/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2011254668
• 本文言語コード: en
• データソース種別:
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  • Crossref
  • CiNii Articles
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