Articles producció científica> Ciències Mèdiques Bàsiques

Anticoagulation control with acenocoumarol or warfarin in non-valvular atrial fibrillation in primary care (Fantas-tic study)

  • Identification data

    Identifier: imarina:9216907
    Authors:
    Rosa Dalmau Llorca MMartín CACarrasco-Querol NRojas ZHDrago EFCumplido DRBlanco ECGonçalves AQFernández-Sáez J
    Abstract:
    Introduction: The use of vitamin K antagonists (VKAs) in non-valvular atrial fibrillation (NVAF) is complicated due to the narrow therapeutic margin they present and their unpredictable dose–response relationship. Most studies are based on warfarin, with the results being extrapolated to acenocoumarol. However, studies comparing the two treatments in terms of the degree of antico-agulation control are scarce, justifying the present study. Main factors associated with poor control of time in therapeutic range (TTR) of anticoagulated patients are also studied. Methods: Cross-sectional study, with real-world data from patients treated in primary care (PC). Data were obtained from the System for the Improvement of Research in PC (SIDIAP) database, covering 60,978 NVAF-anticoagulated patients from 287 PC centres in 2018. Descriptive statistics were derived, and odds ratios were estimated by multivariate logistic regression. Results: 41,430 patients were considered: 93% were being treated with acenocoumarol and 7% with warfarin. There was no difference in poor control of TTR between the two types of VKA treatment, acenocoumarol and warfarin (38.9 vs. 38.4; p = 0.610). Poor anticoagulation control was mainly associated with advanced alcoholism (OR = 1.38), liver failure (OR = 1.37) and intracranial haemorrhage (OR = 1.35) as well as female sex, age < 60 years, cardiovascular history, diabetes mellitus and other variables. Conclusions: There is no association between poor anticoagulation control and the type of VKA treatment administered. Factors associated with poor control of TTR must be considered in clinical practice to improve control and decision-making.
  • Others:

    Author, as appears in the article.: Rosa Dalmau Llorca M; Martín CA; Carrasco-Querol N; Rojas ZH; Drago EF; Cumplido DR; Blanco EC; Gonçalves AQ; Fernández-Sáez J
    Department: Ciències Mèdiques Bàsiques
    URV's Author/s: Castro Blanco, Elisabet / Hernández Rojas, Zojaina
    Keywords: Warfarin Vitamin k antagonists Time in therapeutic range Stroke Quality Prevention Pharmacokinetics Cost-effectiveness Atrial fibrillation Acenocoumarol
    Abstract: Introduction: The use of vitamin K antagonists (VKAs) in non-valvular atrial fibrillation (NVAF) is complicated due to the narrow therapeutic margin they present and their unpredictable dose–response relationship. Most studies are based on warfarin, with the results being extrapolated to acenocoumarol. However, studies comparing the two treatments in terms of the degree of antico-agulation control are scarce, justifying the present study. Main factors associated with poor control of time in therapeutic range (TTR) of anticoagulated patients are also studied. Methods: Cross-sectional study, with real-world data from patients treated in primary care (PC). Data were obtained from the System for the Improvement of Research in PC (SIDIAP) database, covering 60,978 NVAF-anticoagulated patients from 287 PC centres in 2018. Descriptive statistics were derived, and odds ratios were estimated by multivariate logistic regression. Results: 41,430 patients were considered: 93% were being treated with acenocoumarol and 7% with warfarin. There was no difference in poor control of TTR between the two types of VKA treatment, acenocoumarol and warfarin (38.9 vs. 38.4; p = 0.610). Poor anticoagulation control was mainly associated with advanced alcoholism (OR = 1.38), liver failure (OR = 1.37) and intracranial haemorrhage (OR = 1.35) as well as female sex, age < 60 years, cardiovascular history, diabetes mellitus and other variables. Conclusions: There is no association between poor anticoagulation control and the type of VKA treatment administered. Factors associated with poor control of TTR must be considered in clinical practice to improve control and decision-making.
    Thematic Areas: Zootecnia / recursos pesqueiros Serviço social Saúde coletiva Química Public, environmental & occupational health Public health, environmental and occupational health Psicología Pollution Odontología Nutrição Medicina iii Medicina ii Medicina i Materiais Interdisciplinar Health, toxicology and mutagenesis Geografía Geociências Farmacia Environmental sciences Ensino Engenharias ii Engenharias i Enfermagem Educação física Educação Ciencias sociales Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Ciências ambientais Ciências agrárias i Ciência da computação Biotecnología Biodiversidade Astronomia / física Administração pública e de empresas, ciências contábeis e turismo
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: zojaina.hernandez@estudiants.urv.cat elisabet.castro@estudiants.urv.cat
    Record's date: 2021-10-10
    Journal volume: 18
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://www.mdpi.com/1660-4601/18/11/5700
    Papper original source: International Journal Of Environmental Research And Public Health. 18 (11):
    APA: Rosa Dalmau Llorca M; Martín CA; Carrasco-Querol N; Rojas ZH; Drago EF; Cumplido DR; Blanco EC; Gonçalves AQ; Fernández-Sáez J (2021). Anticoagulation control with acenocoumarol or warfarin in non-valvular atrial fibrillation in primary care (Fantas-tic study). International Journal Of Environmental Research And Public Health, 18(11), -. DOI: 10.3390/ijerph18115700
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Article's DOI: 10.3390/ijerph18115700
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2021
    Publication Type: Journal Publications
  • Keywords:

    Environmental Sciences,Health, Toxicology and Mutagenesis,Pollution,Public Health, Environmental and Occupational Health,Public, Environmental & Occupational Health
    Warfarin
    Vitamin k antagonists
    Time in therapeutic range
    Stroke
    Quality
    Prevention
    Pharmacokinetics
    Cost-effectiveness
    Atrial fibrillation
    Acenocoumarol
    Zootecnia / recursos pesqueiros
    Serviço social
    Saúde coletiva
    Química
    Public, environmental & occupational health
    Public health, environmental and occupational health
    Psicología
    Pollution
    Odontología
    Nutrição
    Medicina iii
    Medicina ii
    Medicina i
    Materiais
    Interdisciplinar
    Health, toxicology and mutagenesis
    Geografía
    Geociências
    Farmacia
    Environmental sciences
    Ensino
    Engenharias ii
    Engenharias i
    Enfermagem
    Educação física
    Educação
    Ciencias sociales
    Ciências biológicas iii
    Ciências biológicas ii
    Ciências biológicas i
    Ciências ambientais
    Ciências agrárias i
    Ciência da computação
    Biotecnología
    Biodiversidade
    Astronomia / física
    Administração pública e de empresas, ciências contábeis e turismo
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