- Title
- A factor VII-based method for the prediction of anticoagulant response to warfarin
- Creator
- Ooi, Qing-Xi; Wright, Daniel F. B.; Isbister, Geoffrey K.; Duffull, Stephen B.
- Relation
- Scientific Reports Vol. 8, Issue 1
- Publisher Link
- http://dx.doi.org/10.1038/s41598-018-30516-4
- Publisher
- Nature Publishing Group
- Resource Type
- journal article
- Date
- 2018
- Description
- Warfarin dosing methods based on existing models for warfarin and the international normalised ratio (INR) give biased maintenance dose predictions at the upper and lower quantiles of dose requirements. The aim of this work is to propose a conceptually different approach to predict INR after warfarin dosing. Factor VII concentration was proposed as the principal driving force for the INR. The time to steady-state INR (tSS,INR) was determined based on the INR response to changes in factor VII concentrations following warfarin initiation, and from this the steady-state INR (INRSS) was derived. The proposed method requires timed, paired blood samples of INR and factor VII. At different simulated warfarin dose rates, the prediction error associated with the proposed method was shown to be within clinically acceptable limits for both the tSS,INR (±2 days) and INRSS (±0.2). The use of the method was demonstrated in two patients who were initiated with 5¿mg of warfarin daily. The difference in predicted versus actual steady-state INR were 0.0 and -0.4. The proposed method represents a unique approach to predict the INR. It considers factor VII as the main driver for INR and provides valuable information about the time to steady state INR.
- Subject
- warfarin; international normalised ratio; oral anticoagulant therapy; prediction algorithm
- Identifier
- http://hdl.handle.net/1959.13/1394855
- Identifier
- uon:33780
- Identifier
- ISSN:2045-2322
- Rights
- © The Author(s) 2018. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
- Language
- eng
- Full Text
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