S. Bhuvaneshwari*, D. Jeyalakshmi, Periyanarkunan Ramaiya Murugesan and M. Siva Selva Kumar


Introduction: Warfarin, Acenocoumarol and Phenprocoumon are efficacious anticoagulant drugs for thromboembolic diseses, atrial fibriilation and artificial heart valves. Prescribing correct dose of coumarins is difficult because of pharmacokinetic and pharmacodynamic variations between individuals. They also have low safety margin. Various genetic and non genetic factors are responsible for dosing requirements. Acenocoumarol is a commonly used oral anticoagulant. It’s effects are monitored by INR. It has been found that there is no correlation between dose of Acenocoumarol and INR in clinical practice. Measurement of plasma concentration of Acenocoumarol will help in adjusting the dose. Aim and Objectives: To compare the trough and Cmax Plasma concentrations of Acenocoumarol in mechanical heart valve patients. Methodlogy: After ethics approvals and Patients were recruited into the study after signing informed consent in English or Tamil, Age and sex of the participants were recorded. 2 ml of blood samples were collected for estimating trough and Cmax levels (2hrs after drug). High –performance liquid chromatography Concentration was used to measure the concentrations of Acenocoumarol. Statistical Analysis: student t test was used to compare mean of trough and Cmax concentrations of Acenocoumarol, One way analysis of variance (ANOVA) was used to compare trough and Cmax plasma concentration of Acenocoumarol. Result: 56 patients were enrolled into the study. Among these 28 were males and 28 were females. At 5% level of significance there was no difference between trough and Cmax concentrations of Acenocoumarol. Mean, minimum and maximum plasma concentration was lower with trough than Cmax. But at 5% level of significance there was no difference between trough and Cmax concentration of Acenocoumarol. Conclusion: Trough and Cmax plasma concentration of Acenocoumarol was similar. So plasma concentration of Acenocoumarol can be measured at any time. However it has to be confirmed with larger population, since various factors can affect the plasma concentration of Acenocoumarol.

Keywords: Warfarin, Acenocoumarol and Phenprocoumon.

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