title: Anticoagulation control quality affects the D-dimer levels of atrial fibrillation patients.
abstract: BACKGROUND
  Anticoagulation control quality affects the incidence of thromboembolic events in atrial fibrillation (AF) patients. However, the effects of anticoagulation control quality on the prothrombotic state of AF patients are unclear.
  
  
  RESULTS
  Ninety-five AF patients who had been treated with warfarin were prospectively followed-up for 449 ± 92 days. We analyzed whether time in the therapeutic range (TTR) of the international normalized ratio (INR) of prothrombin time, percentage of INR values in the range (%INR), and coefficient of variation of INR values (CV-INR) were related to D-dimer levels. The mean values of TTR, %INR, and CV-INR were 62%, 59%, and 0.19, respectively, and their median values were 67%, 63%, and 0.19, respectively. TTR was significantly correlated with %INR (R(2) = 0.917, P<0.01), but not with CV-INR (R(2) = 0.050, P = 0.26). The mean and median D-dimer levels were 0.79 and 0.60 µg/ml, respectively. Low TTR, low %INR, and high CV-INR were found to contribute to high D-dimer levels (P = 0.02, 0.03, and 0.02, respectively).
  
  
  CONCLUSIONS
  In AF patients treated with warfarin, not only the duration outside the target INR range, but also the fluctuation in INR level may influence the prothrombotic state.
authors.affiliation: Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Nakatani
authors.forename: Koichi
authors.initials: K
authors.lastname: Mizumaki
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Nishida
authors.forename: Tadakazu
authors.initials: T
authors.lastname: Hirai
authors.forename: Masao
authors.initials: M
authors.lastname: Sakabe
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Oda
authors.forename: Shuji
authors.initials: S
authors.lastname: Joho
authors.forename: Akira
authors.initials: A
authors.lastname: Fujiki
authors.forename: Takashi
authors.initials: T
authors.lastname: Nozawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inoue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000097:blood* / Q000188:drug therapy* / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data; D012307:Risk Factors; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D014859:Warfarin