2012


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2012/№5

How to maximize warfarin therapy effectiveness and safety from the point of view of a clinical pharmacologist?

Sychev D. A., Gavrisiuk E. V., Al-Ahmad Faisal
State Budgetary Educational Institution “I. M. Sechenov First Moscow State Medical University” of the RF Ministry of Health Care, Trubetskaya 8, Bld. 2, Moscow 119991

Keywords: anticoagulation clinics, warfarin, bleeding, portable coagulometer, thrombosis, pharmacogenetic testing, patient schools

DOI: 10.18087 / rhj.2012.5.1708

The review covers methods of increasing efficiency and safety of indirect anticoagulant warfarin. Efficiency of warfarin in patients with high risk of thromboembolic complications has been proved and is not questioned. However, according to foreign and Russian epidemiological researches, not all patients, to whom it warfarin is indicated, take it (according to the Russian data, not more than 51 % of patients who need it), and if it is prescribed, a therapeutic dose often is not adjusted, and efficiency control is often inadequate. It is connected with complex dose selection, coagulation control, risk of bleeding development. Methods of improvement of the Warfarin therapy quality are the following: training of patients in «warfarin» schools, supervision of patients in anticoagulation clinics / rooms, domestic control of the international normalized ratio (INR), pharmacogenetic testing for warfarin dose personification. Efficiency of such approaches has been confirmed in randomized controlled studies, and thus methods can be used in the clinical practice
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Sychev D. A., Gavrisiuk E. V., Al-Ahmad Faisal. How to maximize warfarin therapy effectiveness and safety from the point of view of a clinical pharmacologist? Russian Heart Journal. 2012;11(5):264-271.

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