Comparative Study on Estimation of Acenocoumarol Levels in Blood in Patients with Extremes and Normal INR Values after Valve Replacement Surgery
Journal Title: Journal of Clinical and Diagnostic Research - Year 2018, Vol 12, Issue 10
Abstract
ABSTRACT Introduction: Acenocoumarol is an oral-anticoagulant which is commonly used but with narrow therapeutic index and there is no relation between dose and adverse effects. The response of acenocoumarol varies according to individual. Adverse effect like bleeding occurs even when INR is in normal range. Therapeutic drug monitoring of acenocoumarol is essential to prevent life threatening complication. Aim: To study the association between plasma concentration of acenocoumarol at trough and Cmax levels with their corresponding Internalized Normalised Ratio (INR) values in patients who have undergone valve replacement. Materials and Methods: After Human Ethics Committee approval, 56 patients were enrolled for the study. Participants who were taking acenocoumarol 2 mg with low INR, normal INR and high INR was included. Blood samples taken for estimation of trough and Cmax concentrations of acenocoumarol were analysed by High Performance Liquid Chromatography (HPLC) method. Results: The was no statistically significant correlation between INR of all the three groups and respective plasma concentration of acenocoumarol taken at trough and Cmax by Pearson’s correlation (p-value=0.187). The plasma concentration of acenocoumarol taken at trough and Cmax of all the three groups of participants was not statistically different by ANOVA (p-value=0.164). Conclusion: The present study concludes that measuring INR alone will have limited value for dose adjustment of acenocoumarol as proved by other studies for warfarin. Hence, estimation of plasma concentration of acenocoumarol will be ideal and appropriate for the dose adjustment of acenocoumarol.
Authors and Affiliations
D. Jeyalakshmi, S Bhuvaneshwari, Periyanarkunan Ramaiya Murugesan, M Siva Selva Kumar
Keywords
Related Articles
- EP ID EP525921
- DOI 10.7860/JCDR/2018/31465.12094
- Views 64
- Downloads 0
A study on Association of Antioxidant Status of Red Blood Cells with Type 2 Diabetes
ABSTRACT Introduction: Oxidative stress plays a role in the pathogenesis of type 2 Diabetes either by effecting insulin secretion or increasing resistance to insulin. Oxidative stress is dealt by the body with the help o...
Patient Satisfaction with Dental Services and Associated Factors in a Saudi Dental Institution
ABSTRACT Introduction: Patient satisfaction is associated with improved compliance and better health outcomes. However, the factors related to patient satisfaction are not fully understood. Aim: To evaluate patient satis...
Comparison of Accuracy of Bracket Placement by Direct and Indirect Bonding Techniques using Digital Processing - An In-Vitro Study
ABSTRACT Introduction: Accuracy of bracket positioning is an essential part of successful orthodontic treatment. Ideally placed brackets help in treatment mechanics and improve consistency of the result. The current stud...
Non Iodine Avid Bone Metastasis from Differentiated Thyroid Cancer: A Case Series
Differentiated Thyroid Carcinoma (DTC) constitute up to 90 per cent of all thyroid malignancy. The overall prognosis of patients with DTC is good, but when bone metastases are present, the overall survival at 10 years ra...
Orthodontic Therapy for Paediatric Cancer Survivors: A Review
The paper aims at reviewing the possibilities of orthodontic therapy for paediatric cancer survivors. It is important to understand the fundamental disease, it’s treatment protocols, effects on growing skeleton, dental d...