South Africa's poor warfarin control raises questions of benefit above other anticoagulant therapies in atrial fibrillation.

摘要

South African patients entered into the ACTIVE-W trial were outside the ideal INR targets of 2-3 for 60% of the time while on warfarin therapy. This poor control of warfarin reduces benefit and raises the question as to whether other newer anticoagulant therapies should be used for stroke prevention in atrial fibrillation. New management strategies are also needed to improve warfarin control. Poor control of warfarin was a very significant feature of the South African-entered patients and, in fact, South Africa as a country was at the bottom of the log of achieved time in therapeutic range (TTR) (See Table 1, amended from reference 1). Furthermore, no South African patients were in the upper quartiles of TTR control.