Author(s): Shilpa Mary Alias, Vishnu S Nair, Parvathy Byju, Praveen G Pai, Remya Reghu


DOI: 10.5958/0974-360X.2021.00001.9   

Address: Shilpa Mary Alias1, Vishnu S Nair1, Parvathy Byju1, Dr. Praveen G Pai2, Remya Reghu1
1Department of Pharmacy Practice, Amrita School of Pharmacy, Kochi – 682041, Amrita Vishwa Vidyapeetham, Kerala.
2Department of Cardiology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kerala.
*Corresponding Author

Published In:   Volume - 14,      Issue - 1,     Year - 2021

Aim: To compare and evaluate the effectiveness of warfarin and acenocoumarol in atrial fibrillation patients. Methods: It was a prospective observational study for a period of 1 year. The effectiveness was determined by comparing individual mean Time in therapeutic range (TTR) calculated using “Fraction of INR in range” method as well as by evaluating stroke risk using CHA2DS2VASc scores. The safety of the drug therapy was assessed from the ADR occurred after the drug administration. The data was analyzed using statistical software (version 20). Result: A total of 218 patients were selected for the study. The mean age of patients treated with acenocoumarol was 57.01±13.07 years and that of patients treated with warfarin was 67.18±12.24 years respectively. Mean TTR was found to be 56.54% ± 19.67 vs 50.69% ± 23.57 for acenocoumarol and warfarin respectively (p value <0.05). After the drug initiation, 12 patients experienced stroke episodes in acenocoumarol group while 24 patients experienced stroke in warfarin treated group (p value <0.05). A total of 463 ADRs were observed during the study period, of which 174 belong to acenocoumarol treated patients and 289 to warfarin group. Among these, bleeding (127 patients) was the main ADR (55 vs 72) with p value of 0.001. Conclusion: This study concluded that acenocoumarol is a better oral anticoagulant compared to warfarin while considering various factors like mean TTRs, ADRs observed, stroke incidence and QOL of patients.

Cite this article:
Shilpa Mary Alias, Vishnu S Nair, Parvathy Byju, Praveen G Pai, Remya Reghu. A Comparative Study on the effect of Warfarin v/s Acenocoumarol in patients with Atrial fibrillation. Research J. Pharm. and Tech. 2021; 14(1):1-5. doi: 10.5958/0974-360X.2021.00001.9

Shilpa Mary Alias, Vishnu S Nair, Parvathy Byju, Praveen G Pai, Remya Reghu. A Comparative Study on the effect of Warfarin v/s Acenocoumarol in patients with Atrial fibrillation. Research J. Pharm. and Tech. 2021; 14(1):1-5. doi: 10.5958/0974-360X.2021.00001.9   Available on:

1.    Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Annals of Internal Medicine. 2007; 146:857–867.
2.    Lip GY, Laroche C, Dan GA et al. A prospective survey in European Society of Cardiology member countries of atrial fibrillation management: baseline results of EUR Observational Research Programme Atrial Fibrillation (EORP-AF) Pilot General Registry.  Europace. 2013;16(3):308-319.
3.    Gage BF, van Walraven C, Pearce L et al. Selecting patients with atrial fibrillation for anticoagulation: stroke risk stratification in patients taking aspirin. Circulation. 2004;110 (16):2287-2292.
4.    Trailokya A. Acenocoumarol in Thromboembolic Disorders. Journal of Cardiovascular Pharmacology. Open Access. 2015; 4:(4).
5.    Annie J, James E, Nambiar V. Impact of Clinical Pharmacist’s Intervention on health outcomes in Post stroke patients. International Journal of Pharmaceutical Research. 2015;7(3):38-43.
6.    Go AS, Hylek EM, Phillips KA et al. Prevalence of Diagnosed Atrial Fibrillation in Adults. Journal of American Medical Association. 2001; 285(18): 2370-2375.
7.    Heeringa J, van der Kuip DA, Hofman A et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. European Heart Journal. 2006;27(8):949-953.
8.    Kaya H, Ertaş F, Kaya Z et al. Epidemiology, anticoagulant treatment and risk of thromboembolism in patients with valvular atrial fibrillation: Results from Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER). Cardiology Journal. 2014; 21(2): 158-162.
9.    Patel SI, Cherington C, Scherber R et al. Assessment of patient adherence to direct oral anticoagulant vs warfarin therapy. The Journal of the American Osteopathic Association. 2017;117(1):7-15.
10.    Kulo A, Kusturica J, Kapid E et al. Better stability of acenocoumarol compared to warfarin treat-ment in one-year observational, clinical study in patients with nonvalvular atrial fibrillation. Medicinski Glasnik  2011; 8(1):9. 2010;14.
11.    Prabhu M A, Pai P G, Vupputuri A et al. Supra Hisian Conduction block as an unusal presenting feature of Takotsubo Cardiomyopathy. Pacing and Clinical Electrophysiology .2017; 40(15):596-599.
12.    Flegel KM, Hanley J. Risk factors for stroke and other embolic events in patients with nonrheumatic atrial fibrillation. Stroke. 1989; 20:1000-1004.
13.    Vazquez FJ, Gonzalez JP, LeGal G et al. Risk of major bleeding in patients receiving vitamin K antagonists or low doses of aspirin. A systematic review and meta-analysis. Thrombosis Research. 2016; 138:1-6.
14.    Ambrosi P, Daumas A, Villani P et al. Meta-analysis of major bleeding events on aspirin versus vitamin K antagonists in randomized trials. International Journal of Cardiology. 2017; 230:572-576.
15.    Reynolds M, Lavelle T, Essebag V et al. Influence of age, sex, and atrial fibrillation recurrence on quality of life outcomes in a population of patients with new-onset atrial fibrillation: The Fibrillation Registry Assessing Costs, Therapies, Adverse events and Lifestyle (FRACTAL) study. American Heart Journal. 2006; 152(6): 1097-1103.
16.    S Archana, Ram M. A Prospective Study on Assessment of Medication Adherence of Patients Towards Antihypersentive Medications. Research Journal of Pharmacy and Technology.  2017; 10(11): 3779-82.

Recomonded Articles:

Research Journal of Pharmacy and Technology (RJPT) is an international, peer-reviewed, multidisciplinary journal.... Read more >>>

RNI: CHHENG00387/33/1/2008-TC                     
DOI: 10.5958/0974-360X 

56th percentile
Powered by  Scopus

SCImago Journal & Country Rank

Recent Articles


Not Available