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Correlation Between Warfarin Levels in the Blood and the Value of Normal INR in Fibrillation Atrium Inpatients Suryoputri, Masita Wulandari; Endriastuti, Nialiana Endah; Ilma, Dewi Latifatul; Azzahra, Alfita
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 14, No 2
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.89898

Abstract

Background: Warfarin is an anticoagulant inhibitor of vitamin K that is effective in preventing systemic embolization in atrial fibrillation patients. Warfarin has a narrow therapeutic index, so it requires monitoring of rates to prevent the occurrence of toxic effects and to ensure the passage of INR values.Objectives: The study aims to find out the correlation between warfarin levels and normal INR values.Methods: Observational research method with the collection of retrospective data on the medical records of patients treated with atrial fibrillation at Prof. Dr. Margono Soekarjo Hospital, Purwokerto, in January 2019–December 2021. Warfarin levels were calculated pharmacokinetically using the steady-state concentration (Css) and plasma concentration (Cp) formulas. Data analysis is carried out using the Spearman test to determine the correlation between warfarin levels and normal INR values.Results: The number of patients with normal INR values was less than the number of patients with abnormal INR values, namely 21 patients and 48 patients. The Spearman test results show a p-value of 0.31 (p>0.05), showing that the correlation between warfarin levels in the blood and the corresponding INR value is not significant (p> 0.05), and the R value in the Spearman test is 0.122, showing that the direction of the correlation is positive with very weak correlation strength.Conclusion: The correlation between warfarin levels in the blood and the appropriate INR value is not significant (p>0.05), where the R value in the Spearman test shows R=0.122, meaning the direction of the correlation is positive with a very weak correlation strength.
Comparison of unfractionated heparin and fondaparinux in relation to the incidence of recurrent myocardial infarction Suryoputri, Masita Wulandari; Astuti, Dwi Aprilia; Endriastuti, Nialiana Endah; Ilma, Dewi Latifatul
JURNAL ILMU KEFARMASIAN INDONESIA Vol 23 No 2 (2025): JIFI
Publisher : Faculty of Pharmacy, Universitas Pancasila

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35814/jifi.v23i2.1680

Abstract

Acute Myocardial Infarction (AMI) is a cardiovascular condition that involves necrosis of the heart muscle because of a decrease in blood supply to the heart caused by an obstruction of the coronary arteries. The prevalence of cardiac disease is 1.5% including AMI, and ranked 4th above all provinces in Indonesia. Anticoagulants are administered for the management of AMI treatment. Anticoagulants are treatments utilized to prevent thrombosis and reduce ischemic injury, preventing hemorrhage from developing in the heart's arteries and veins. Unfractionated heparin (UFH) and fondaparinux are both anticoagulants, that are utilized frequently in the treatment of AMI-EST patients. In decreasing the production of thrombin and preventing coagulation, unfractionated heparin, and fondaparinux can avoid death and recurrent myocardial infarction. The research was conducted as an observational study with retrospective data collection from medical records of inpatients diagnosed with acute transmural myocardial infarction of the anterior wall at Prof. Dr. Margono Soekarjo Purwokerto from January 2019 to December 2021. The chi-square test was used to examine the association between the type of anticoagulant therapy (unfractionated heparin or fondaparinux) and the incidence of recurrent myocardial infarction. The statistical analysis showed a significant association between the type of anticoagulant therapy and the incidence of recurrent myocardial infarction (p < 0.05). A higher proportion of patients treated with fondaparinux did not experience recurrent myocardial infarction compared to those treated with unfractionated heparin, suggesting that fondaparinux may be more effective in preventing recurrence.