Efectividad y seguridad del tratamiento anticoagulante con acenocumarol en fibrilación auricular no valvular / Effectiveness and safety of oral anticoagulation treatment with acenocoumarol in non-valvular atrial fibrillation
Rev. méd. Chile
; 145(10): 1243-1251, oct. 2017. tab, graf
Artigo
em Espanhol
| LILACS
| ID: biblio-902438
Biblioteca responsável:
CL1.1
RESUMEN
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 andMethods:
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.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Contexto em Saúde:
ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
Problema de saúde:
Doença Cardiovascular
/
Doença Cerebrovascular
/
Outras Neoplasias Malignas
Base de dados:
LILACS
Assunto principal:
Fibrilação Atrial
/
Acidente Vascular Cerebral
/
Acenocumarol
/
Anticoagulantes
Tipo de estudo:
Estudo de etiologia
/
Estudo observacional
/
Estudo prognóstico
Limite:
Idoso
/
Idoso, 80 anos ou mais
/
Feminino
/
Humanos
/
Masculino
Idioma:
Espanhol
Revista:
Rev. méd. Chile
Assunto da revista:
Medicina
Ano de publicação:
2017
Tipo de documento:
Artigo
País de afiliação:
Chile
Instituição/País de afiliação:
Universidad de La Frontera/CL