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passages: document
passages: Quality of individual INR control and the risk of stroke and bleeding events in atrial fibrillation patients : a nested case control analysis of the ACTIVE W study . INTRODUCTION Time in therapeutic range ( TTR ) for international normalized ratio ( INR ) is an accepted quality measure of anticoagulation control in patient populations , but its usefulness for predicting stroke and bleeding in individuals is not well understood . MATERIALS AND METHODS In a nested case control analysis among ACTIVE W study patients , cases with stroke and cases with bleeding were separately matched with controls . Several anticoagulation quality measures were compared , overall and in a time-dependent manner . RESULTS 32 cases with ischemic stroke and 234 cases with bleeding in the analysis were matched in a 4:1 ratio to 122 and 865 controls , respectively . Follow-up duration was 257±154days for the stroke analysis and 222±146days for the bleeding analysis . Compared with their respective controls , the study mean TTR of both stroke cases ( 53.9 % ±25.1 vs 63.4 % ±24.8 ; p=0.055 ) and bleeding cases ( 56.2 % ±25.4 vs 63.4 % ±26.8 ; p < 0.001 ) was lower . Time below range for stroke and time above range for bleeding were only greater in the last month leading up to the event , not over the entire study period . Rather , over the entire study period bleeding cases spent more time below range than controls ( 26.8 % ±25.9 vs 20.8 % ±24.0 ; p=0.001 ) . CONCLUSIONS TTR was lower in individual AF patients with stroke or bleeding compared with matched controls in ACTIVE W. Maintaining a high TTR , with equal importance to avoid low and high INRs , is a relevant goal of individual patient treatment to prevent stroke and bleeding .
entities: 2242
entities: Intervention_Other
entities: Time in therapeutic range ( TTR )
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entities: Intervention_Other
entities: TTR
entities: 2244
entities: Outcome_Physical
entities: Time in therapeutic range ( TTR )
entities: 2245
entities: Outcome_Physical
entities: Time below range for stroke
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entities: Outcome_Physical
entities: time above range for bleeding
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entities: Participant_Condition
entities: atrial fibrillation patients :
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entities: Participant_Condition
entities: ACTIVE W study patients , cases with stroke and cases with bleeding were separately matched with controls .
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entities: Participant_Sample-size
entities: 32
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entities: Participant_Condition
entities: cases with ischemic stroke
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entities: Participant_Sample-size
entities: 234
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entities: Participant_Condition
entities: cases with bleeding