Efectividad y seguridad del tratamiento anticoagulante con acenocumarol en fibrilación auricular no valvular

Abstract

Effectiveness and safety of oral anticoagulation treatment with acenocoumarol in non-valvular atrial fibrillation Background: Vitamin K antagonists significantly decrease the incidence of stroke but increase the risk of bleeding. Aim: To assess the effectiveness and risk of bleeding of vitamin K antagonists in non-valvular atrial fibrillation. Material and Methods: Retrospective cohort study of 524 patients, 236 women (45%) and 288 men (55%) with non-valvular atrial fibrillation (NVAF) admitted to the oral anticoagulation treatment (OAT) clinic at four public hospitals, between 2009 and 2012. They were followed until March 2013, measuring the quality of OAT, ischemic and bleeding events. Results: The mean follow-up was 26.1 months, with 1,154.7 person-years of follow-up accrued. The percentage of time in therapeutic range (TTR) was 35.2 ± 18%; this was deemed to represent the quality of OAT. The cumulative incidence of ischemic events, either stroke or systemic embolism, was 2.25/100 person-years, being greater in patients with previous embolism (Risk ratio 5.21, 95% confidence intervals 2. 31-11.73, p < 0.01). The cumulative incidence of major bleeding events -extracranial and intracraneal-was 4.08/100 person-years. The main site of extracranial major bleeding was the gastrointestinal tract (32%). Conclusions: In our clinical practice, the effectiveness of OAT with acenocoumarol in NVAF patients is similar to that published abroad. However, the incidence of bleeding complications is higher. The quality of the OAT measured by the TTR was lower than abroad. (Rev Med Chile 2017; 145: 1243-1251

Profile and clinical indicators of an anticoagulation domiciliary program in Bogota.

“…The success of anticoagulant therapy and the reduction of preventable adverse events, specifically with the warfarin therapy, could be explained, in a large extent, to the health education and periodic monitoring of INR and PT, as well as the existence of a direct channel of direct communication with the health team. This coincides with the results of a study made in Chile by Castro et al, who emphasize that the quality of the oral anticoagulant treatment is firmly related not only with the incidence of embolic and thrombosis complications but also with the gravity of these, being frequent monitoring necessary (31). In that sense, Miranda et al, agree with the monitorization and the strict control of the anticoagulant therapy, reducing the risk of thrombotic events or bleeding (32).…”

Nuevos anticoagulantes orales y antiagregantes plaquetarios, en el período perioperatorio de cirugía no cardíaca. Parte 1: Nuevos anticoagulantes directos

“…Afecta al 1 a 2% de la población general y su prevalencia aumenta con la edad. En Chile no hay información exacta de esta patología, pero se piensa que sería similar a los estudios internacionales [2]. El tromboembolismo pulmonar es una de las causa de muerte prevenible más frecuente en pacientes hospitalizados por procedimientos quirúrgicos [3], por lo que el manejo de los anticoagulantes en este tipo de pacientes, también es relevante.…”