A Prospective Observational Study to Assess the Quality of Warfarin Therapy and Validate the Impact of Has Bled and Cha2ds2-Vasc Score in the Prevention of Stroke in Indian Atrial Fibrillation Patients

Abstract

The aim of this study is to evaluate the quality of warfarin therapy and validate the impact of HAS-BLED and CHA2DS2-VSc score in thrombo prophylaxis for Indian atrial fibrillation patients. This was a prospective observational study which was conducted for a period of 6 months (February 2018-July 2018) at a tertiary care hospital of Trivandrum, Kerala and consisted of 92 patients. Time in therapeutic range (TTR) was assessed using Rosendaal method. Stroke risk and bleeding risk was assessed using CHA2DS2-VASc and HAS-BLED scores. The overall mean TTR value of 92 patients was 50.01 ± 29.38. The mean TTR values of good control group and poor control group were 74.58 ± 12.77 and 26.73 ± 20.09 (< 0.05 p value). Stroke risk and bleeding risk of the overall population was 3.09 ± 98.40 and 2.73 ± 1.62. The mean CHA2DS2-VASc and HAS-BLED score of the good control group was found to be 2.56 ± 68.54 and 1.36 ± 65.02 whereas for the poor control group, it was 3.58 ± 96.38 and 4 ± 1.16 (< 0.05 p value). Bleeding occurred only in the poor control group (10.9%) So, the overall quality of warfarin therapy in Indian atrial fibrillation patients was found to be suboptimal and the predictive ability of risk stratification scores was found to be useful.