انتشار الحوادث الضارة و التداخلات الدوائية لدى مرضى سوريين يتداوون بالوارفارين

Abstract EN

Despite being the most widely used anticoagulant, warfarin continues to be one of the most problematic drugs due to its narrow therapeutic index, wide inter-individual variability in patient response, and serious adverse effects (ADRs) aggravated by a long list of interacting drugs.

the aim of this study was to investigate the frequency of adverse events and evaluate prevalence of drug interactions in Syrian patients on warfarin.

our cross-sectional study included 350 patients treated with warfarin for indications included atrial fibrillation, replacement of heart valves, or deep venous thrombosis.

the mean age of the patients was 53.2±17.4 years, and females constituted 44.3%.

the majority of patients, 243 (72%) used at least one drug that could affect warfarin's pharmacodynamics (i.e; aspirin or clopidogrel), or pharmacokinetics (warfarin metabolism inhibitors).

And 221 (63.6%) patients had comorbidities, that may adversely alter the efficacy of treatment.

131 (48%) of the patients experienced adverse events (bleeding, thrombosis, or both) that occurred more frequently in patients with comorbidities or interacting drugs.

our study provides evidence of high prevalence of ADRs and drug interactions in Syrian patients, and calls for activation of coumarin clinics and signifies the need for raising awareness of appropriate INR monitoring regimens, particularly in high risk populations (elderly, comorbidities, and polypharmacy).