ABC | Volume 114, Nº3, March 2020

Original Article Silva et al. Warfarin therapy in NVAF patients in Brazil Arq Bras Cardiol. 2020; 114(3):457-466 Table 1 – Patient characteristics and metrics per TTR quartile Values Period (months) 4 – 24 6 – 24 (Sensitivity analysis) Q1 N = 303 Q2 N = 306 Q3 N = 305 Q4 N = 306 Total N = 1220 N = 934 Demographics Age (mean/±SD) 62.02 (±15.92) 64.58 (±13.83) 64.49 (±14.48) 64.30 (±14.63) 63.85 (±14.75) 64.75 (±14.03) Female (%) 50.8 55.2 52.5 44.1 50.7 51.5 Anticoagulation INR (mean/±SD) 2.56 (± 1.25 ) 2.67 (± 1.10) 2.61 (± 0,89) 2.54 (± 0,62) 2.60 (±0.88) 2.60 (±0.96) INR (median/IQR) 2.22 (1.70-3.16) 2.50 (1.97-3.20) 2.48 (2.06-2.98) 2.44 (2.13-2,78) 2.44 (1.99-3.00) 2.43 (2.00-3.00) TTR (mean/±SD) 32.6% (±11.5%) 51.2% (±3.3%) 62.0% (±3.2%) 80.2% (±9.8%) 56.6% (±18.9%) 58.0% (±16.2%) TTR (median/IQR) 36% (28-42%) 52% (48-54%) 62% (59-65%) 78% (72-86%) 58% (47-68%) 57.0% (45-68%) INR tests per patient (mean/±SD) 12.79 (±8.09) 17.49 (±9.65) 18.00 (±9.27) 14.20 (±8.40) 15.63 (±9.13) 18.44 (±8.60) Risk factors and baseline conditions CHA 2 DS 2 -VASc (mean/±SD) 2.38 (±1.72) 2.46 (±1.69) 2.55 (±1.69) 2.44 (±1.74) 2.45 (±1.71) 2.58 (±1.72) Stroke (%) 13.9 12.1 11.5 17.3 13.7 14.6 Hypertension (%) 33.3 39.2 43.6 37.9 38.5 41.3 Diabetes (%) 13.2 14.4 15.4 11.4 13.6 14.5 Chronic kidney failure (%) 4.6 2.0 4.3 2.6 3.4 3.0 Congestive heart failure (%) 20.5 18.3 21.3 19.0 19.8 21.1 Region Southeast 86.8 85.9 85.6 84.3 85.7 85.9 Central 6.9 8.2 8.5 9.8 8.4 8.6 South and Northeast 6.3 6.0 5.9 5.9 6.0 5.5 Concomitant medications Phenprocoumon 11 6 5 11 33 26 Aspirin 10 6 15 0 31 25 Clopidogrel 7 5 2 2 16 9 Aspirin + clopidogrel 3 0 1 0 4 2 Statins 27 29 33 29 118 99 Nitrate 2 3 5 6 16 14 Amiodarone 1 3 3 3 10 7 Follow-up Months of monitoring (mean/±SD) 13.87 (± 7.37) 16.04 (± 7.29) 18.02 (± 7.02) 17.24 (± 7.11) 16.30 (± 7.36) 18.13 (± 6.45) Months of monitoring (median/IQR) 14.00 (7.0-20.0) 17.00 (9.0-23.0) 21.00 (12.0-24.0) 19.00 (11.0-23.0) 18.00 (10.0-23.0) 20.00 (13.0-23.0) CHA 2 DS 2 -VASc: congestive heart failure, hypertension, age, diabetes mellitus, stroke/TIA, vascular disease, age, sex category; IQR: interquartile range; SD: standard deviation; TTR: time in therapeutic range. bit more than half of the time within the therapeutic range. 32 The reported TTR levels for the overall population treated with warfarin in this study were slightly below the lower limit of the recommended threshold interval. 9,11,25 An interesting finding is that the TTR distribution in Figure 2B was skewed to the right, meaning that there was a niche of patients with very high TTR control. Around 22% of patients had TTR > 70%. International data that assessed the association between warfarin control and outcomes indicate that poor warfarin control patients experience more unfavorable clinical and economic outcomes than well controlled patients. 21,33 The results of the present study are quite aligned with prior work and further contribute to the understanding of how warfarin control could impact on both clinical events 461