Factors Analysis of Anticoagulant Treatment of Patients with Non-valvular Atrial Fibrillation

OBJECTIVE To investigate the application of anticoagulant therapy in patients with non-valvular atrial fibrillation, analyze the factors that may affect anticoagulation therapy, and explore the role of clinical pharmacists in anticoagulation management. METHODS Two hundred thirty eight patients with non-valvular atrial fibrillation who were admitted to The Third Affiliated Hospital of Soochow University were collected for retrospective analysis of anticoagulant drug selection, dosage, international standardized ratio(INR), monitoring frequency of coagulation function, combined medication, basic diseases and hemorrhagic complications, medical education. RESULTS The standardized anticoagulant coverage rate was 48.8% in the patients with non-valvular atrial fibrillation with stroke risk score(CHA₂DS₂-VAS_c score) ≥ 2, age and combining with coronary heart disease might affect the clinical anticoagulant drugs selection, and clinical pharmacists provided medication education for patients had significant statistical significance(P< 0.01) whether patients accepted anticoagulant therapy. Before discharge, only 38.16%(29/76) of the patients in the target range were treated, and the average TTRs was(49.57±3.68)%. Age, gender, initial dose of warfarin, bleeding risk, drug combination did not affect the INR meeting to treatment standard, only combined with digestive tract disease had statistical significance(P=0.027). Monitoring frequency of coagulation function in patients also affects INR success rate(P=0.038). CONCLUSION At present coverage rate of anticoagulant therapy of hospitalized patients with non-valvular atrial fibrillation is still low, clinical pharmacists can make full use of their own professional knowledge, provide medical education for patients who need anticoagulant therapy, actively involve in the anticoagulation management, improve monitoring frequency of coagulation function during the anticoagulation and improve the anticoagulation success rate, promote the control effect of stroke.