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