| ●総説 |
Efficient dosage regimen for introduction of warfarin treatment
after coronary artery bypass grafting in Japanese patients |
Junichi Kawana,1‚2 Toshiya Koyanagi,3 Tetsuya Sumiyoshi,4
Kazuhiko Hanada,1 Tetsuo Ohno,2 and Hiroyasu Ogata1 |
1 Department of Biopharmaceutics & Clinical Pharmacokinetics, Meiji Pharmaceutical University
2 Department of Pharmacy
3 Department of Cardiology, Sakakibara Heart Institute, Japan Research Promotion Society for Cardiovascular Diseases
4 Department of Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital |
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| We investigated a regimen for introduction of warfarin treatment in patients who had undergone coronary artery bypass grafting （CABG） with the objective of shortening the time needed to determine the individual optimal dose of warfarin. We initiated warfarin treatment with five different regimens and compared the percentage of patients whose thrombotest （TT） values ranged between 10 and 20% （corresponding to a PT-INR of 1.8–2.8） on the 9th day, after starting warfarin administration. Using a regimen in which warfarin was administered at 5 mg/day on the 1st day as the loading dose, at 3 mg/day from the 2nd day as the maintenance dose, and in which the dose was adjusted on the 7th day or later based on the TT value, the percentage of patients achieving the optimal warfarin dose on the 9th day was 73.1%. This regimen has reached the optimal dose of warfarin more efficiently compared with other four methods. In this regimen, the serious adverse events, such as major bleeding and thromboembolism, did not occur. This method was considered to be most efficient and safe regimen for introduction of warfarin treatment after CABG for determination of the individual optimal dose within 10 days of a procedure. |
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| Keyword： warfarin, anticoagulant therapy, coronary artery bypass |
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