| Objective: Through visiting the patients with AF (atrial fibrillation) who are accepting the anticoagulation therapy of warfarin, and retrospectively analyzing multiple factors which effected warfarin dosing and relationship of dosing and INR, we try to discuss a technique of effective and safe application of warfarin.Methods: Retrospective analysis of hospital records were taken from 45 patients with primary diagnosis of AF, from February 2008 to April 2010 inpatients in department both cardiology and geriatrics. All the patients settle in Yunnan province who have similar life surrounding male and female cases were 26 and 19 respectively. Mean age was(61.3±12.0)years old. Of the total patients, we diagnosed 22 cases with hypertension, 12 cases with chronic heart failure, 3 cases with type 2 diabetes and 3 cases with old cerebral infarction. Situations of warfarin dosing, INR, bleeding and stroke complications were recorded during visiting period. Patients enrolled were devided into group A with starting dose 1.25mg/d or 1.5mg/d, group B with starting dose 2.5mg/d or 3mg/d, group C with maintaining dose less 2mg/d, group D with maintaining dose 2-3.5mg/d, group E with maintaining dose exceeding 3.5mg/d. In the case of dose unchanged, it's considered as reaching the mark when INR stability in 2.0-3.0.Results: After a week of warfarin therapy, the percentage of INR up to the standards, in group A is 14.3 %, group B is 48.2 %, the standard rate of INR, group A is higher than the B (P=0.018). INR a week when the value is greater than 3.0, a group 0 case, b group 2 cases, the two groups of difference there is no statistical significance, p=0.331. The age of group A is older than the B's (69.57±10.98 vs. 57.58±10.59 years, P=0.001) .There is no difference of weight, gender between group A and B and no difference of age, weight, gender between group C, D and E. INR of group A is greater than B before warfarin therapy (1.10±0.12 vs. 1.04±0.09, P=0.038) .On the other hand, the values of INR are no statistical significance between groups of C, D and E. C group's INR value was detected a total of six times greater than 3.0( 12.0%), D and E respectively 3.0% and 2.0%, and there are different between the value of a statistical significance. Each group's average maintaining dose are different in statistics(C as 0.738±0.152mg/INR, D as 1.230±0.267mg/INR, E as 2.056±0.379mg/INR, P<0.001) . There are linear regression equations of each warfarin maintaining dose group, C: INR=1.019+ 0.783×dosing, D: INR=1.066+0.409×dosing, E:INR=0.982+0.233xdosing.Conclusions: There are safe and effective that AF patients who received warfarin therapy canonically. Native AF patients who choose 2.5mg/d or3mg/d as starting warfarin dose, possess of higher INR standardized rate than people who received lower dose, and furthermore, it dosen't increase the incidence of over-anticoagulation(INR>3.0). There is no difference of age, weight, gender between patients whose maintaining warfarin dose are different. Those person who hold lower maintaining dose are more tendential of over-anticoagulation(INR>3.0). According to diversity of maintaining warfarin dose, we get hold of 3 linear regression equations which may be useful when doctors anticipate the range of INR after adjusted the dose of warfarin.
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