Abstract

GOMEZ, Andreina et al. Calidad de la anticoagulación oral con warfarina en una policlínica de cardiología: porcentaje de tiempo en rango terapéutico. Rev.Urug.Cardiol. [online]. 2014, vol.29, n.3, pp.311-316. ISSN 1688-0420.

Background: the efficacy and safety of warfarin in preventing thrombosis in patients with atrial fibrillation/flutter or prosthetic valves depends on adequate anticoagulation levels expressed as INR (International Randomized Ratio). The percentage of time in therapeutic range (TTR) assesses the quality of warfarin anticoagulation and is inversely associated with the presence of thrombotic or hemorrhagic complications. Objective: to assess the quality of anticoagulation through analysis of TTR. Identify factors associated with an adequate level of anticoagulation (TTR³65%). Method: observational, retrospective and analytic study of a cohort of 117 patients anticoagulated with warfarin from June 1, 2012 to July 31, 2013. The individual TTR was calculated using Rosendaal method (linear interpolation). The variables analyzed were age, sex, indication for anticoagulation, level of education, degree of adherence, family status, comorbidities and number of concomitant drugs. X² test was used for statistical analysis of categorical variables. Result: mean age was  67 ± 14  years, 62 % were female and indication for anticoagulation was FA in 63% and mechanical valve in 37% of patients. The mean TTR was 56,6%. Only 38% had an adequate TTR and it was associated with age between 50-74 years (70.5%) (p=0,04) and concomitant use of 3 or more drugs (79.5%) (p=0,044). Conclusion: The mean TTR was below the value defined as good control. Better control was associated with younger age and use of three or more drugs. These results support the development of strategies for a better quality of assistance.

Keywords : WARFARIN; INTERNATIONAL NORMALIZED RATIO.

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