Study about Causes of not being INR in therapeutic range in patients with acute ischemic stroke due to atrial fibrillation cardiac rhythm

Abstract

: The purpose of this study was to investigate the causes of INR not being in the therapeutic range in patients with acute ischemic stroke due to atrial fibrillation.Materials and Methods: Current cross-sectional study was conducted at Imam Reza Hospital in Tabriz during a ten-month period (June to March). Samples were collected from all patients with acute ischemic stroke admitted to Imam Reza Hospital. Subsequently patients with AF heart rhythm who had an INR out of therapeutic range (INR = 2-3) were identified. Then in a face-to-face interview, based on the prepared checklist the causes of INR not being in the therapeutic range were investigated.Results: The study was conducted in a ten months period (from June,22 to March,20 2019 ) during which 810 patients with acute ischemic stroke were admitted to Imam Reza Hospital, 177 of these patient had AF cardiac rhythm (21.8%).Only 1 patient had INR in the therapeutic range and 10 patients were being treated with Rivaroxaban and Enoxaparin which were excluded and eventually 166 patients were enrolled into study . 133 patients (80.1%) were unaware of their heart disease. Of the 33 patients who were aware of their heart disease, 29 patients were treated with Warfarin and 2 patients were untreated due to medication discontinuation by the patient and in 2 cases Warfarin was not prescribed. The main cause of INR not being in therapeutic range in 29 patients treated by Warfarin is the irregular visits to the physician and the inconsistent use of prescribed medication.