Abstract
IntroductionMany factors affect the required dose of warfarin, including body weight, which is mentioned only in a few studies. Our study was conducted using body mass index (BMI) to assess the requirements for warfarin dosing.MethodsA retrospective study was conducted that included adults who used warfarin for more than three months, with at least two consecutive international ratio (INR) readings within the therapeutic range.ResultsOver 301 patients were included; the 20% higher dose of warfarin was required in obese patients than normal BMI and overweight patients (32.2 ± 15.2 vs. 27.4 ±17.3 and 26.8 ± 12.7; p=0.013, respectively).ConclusionObese patients required a higher dose than other patients, which should be considered when initiating or adjusting the warfarin dose.
Highlights
Many factors affect the required dose of warfarin, including body weight, which is mentioned only in a few studies
Over 301 patients were included; the 20% higher dose of warfarin was required in obese patients than normal body mass index (BMI) and overweight patients (32.2 ± 15.2 vs. 27.4 ±17.3 and 26.8 ± 12.7; p=0.013, respectively)
Patients included in the study were adults aged 18 years and over who had been on warfarin for at least three months with a therapeutic international ratio (INR) level
Summary
Obese patients required a higher dose than other patients, which should be considered when initiating or adjusting the warfarin dose. Warfarin exerts its activity by inhibiting vitamin K-dependent blood clotting proteins that affect the coagulation cascade factors II, VII, IX, and X. This makes warfarin a very effective antithrombotic agent to prevent and treat thromboembolic complications [1,2,3,4]. Obesity is considered to be a risk factor for developing thrombosis, especially deep vein thrombosis (DVT) and pulmonary embolism (PE). It increases the risk of atrial fibrillation [3, 8,9,10,11]. In this study, we aimed to assess the effect of body weight, and other patient characteristics, on the average weekly dose of warfarin required to stabilize therapeutic INR score over a period of at least three months
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