Comparison of Anticoagulation Quality between Acenocoumarol and Warfarin in Patients with Mechanical Prosthetic Heart Valves: Insights from the Nationwide PLECTRUM Study
Vitamin K antagonists are indicated for the thromboprophylaxis in patients with mechanical prosthetic heart valves (MPHV). However, it is unclear whether some differences between acenocoumarol and warfarin in terms of anticoagulation quality do exist. We included 2111 MPHV patients included in the n...
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MDPI AG
2021-03-01
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| Series: | Molecules |
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| Online Access: | https://www.mdpi.com/1420-3049/26/5/1425 |
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| author | Danilo Menichelli Daniela Poli Emilia Antonucci Vittoria Cammisotto Sophie Testa Pasquale Pignatelli Gualtiero Palareti Daniele Pastori the Italian Federation of Anticoagulation Clinics (FCSA) |
| author_facet | Danilo Menichelli Daniela Poli Emilia Antonucci Vittoria Cammisotto Sophie Testa Pasquale Pignatelli Gualtiero Palareti Daniele Pastori the Italian Federation of Anticoagulation Clinics (FCSA) |
| author_sort | Danilo Menichelli |
| collection | DOAJ |
| description | Vitamin K antagonists are indicated for the thromboprophylaxis in patients with mechanical prosthetic heart valves (MPHV). However, it is unclear whether some differences between acenocoumarol and warfarin in terms of anticoagulation quality do exist. We included 2111 MPHV patients included in the nationwide PLECTRUM registry. We evaluated anticoagulation quality by the time in therapeutic range (TiTR). Factors associated with acenocoumarol use and with low TiTR were investigated by multivariable logistic regression analysis. Mean age was 56.8 ± 12.3 years; 44.6% of patients were women and 395 patients were on acenocoumarol. A multivariable logistic regression analysis showed that patients on acenocoumarol had more comorbidities (i.e., ≥3, odds ratio (OR) 1.443, 95% confidence interval (CI) 1.081–1.927, <i>p</i> = 0.013). The mean TiTR was lower in the acenocoumarol than in the warfarin group (56.1 ± 19.2% vs. 61.6 ± 19.4%, <i>p</i> < 0.001). A higher prevalence of TiTR (<60%, <65%, or <70%) was found in acenocoumarol users than in warfarin ones (<i>p</i> < 0.001 for all comparisons). Acenocoumarol use was associated with low TiTR regardless of the cutoff used at multivariable analysis. A lower TiTR on acenocoumarol was found in all subgroups of patients analyzed according to sex, hypertension, diabetes, age, valve site, atrial fibrillation, and INR range. In conclusion, anticoagulation quality was consistently lower in MPHV patients on acenocoumarol compared to those on warfarin. |
| first_indexed | 2024-03-09T05:12:59Z |
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| institution | Directory Open Access Journal |
| issn | 1420-3049 |
| language | English |
| last_indexed | 2024-03-09T05:12:59Z |
| publishDate | 2021-03-01 |
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| series | Molecules |
| spelling | doaj.art-5fc7a0e4717645af8d75df534946f6e82023-12-03T12:47:31ZengMDPI AGMolecules1420-30492021-03-01265142510.3390/molecules26051425Comparison of Anticoagulation Quality between Acenocoumarol and Warfarin in Patients with Mechanical Prosthetic Heart Valves: Insights from the Nationwide PLECTRUM StudyDanilo Menichelli0Daniela Poli1Emilia Antonucci2Vittoria Cammisotto3Sophie Testa4Pasquale Pignatelli5Gualtiero Palareti6Daniele Pastori7the Italian Federation of Anticoagulation Clinics (FCSA)I Clinica Medica, Atherothrombosis Centre, Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, ItalyThrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, ItalyArianna Anticoagulazione Foundation, 40138 Bologna, ItalyDepartment of General Surgery and Surgical Specialties “Paride Stefanini”, Sapienza, University of Rome, 00185 Rome, ItalyDepartment of Laboratory Medicine, Haemostasis and Thrombosis Center, AO Istituti Ospitalieri, 26100 Cremona, ItalyI Clinica Medica, Atherothrombosis Centre, Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, ItalyArianna Anticoagulazione Foundation, 40138 Bologna, ItalyI Clinica Medica, Atherothrombosis Centre, Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, ItalyVitamin K antagonists are indicated for the thromboprophylaxis in patients with mechanical prosthetic heart valves (MPHV). However, it is unclear whether some differences between acenocoumarol and warfarin in terms of anticoagulation quality do exist. We included 2111 MPHV patients included in the nationwide PLECTRUM registry. We evaluated anticoagulation quality by the time in therapeutic range (TiTR). Factors associated with acenocoumarol use and with low TiTR were investigated by multivariable logistic regression analysis. Mean age was 56.8 ± 12.3 years; 44.6% of patients were women and 395 patients were on acenocoumarol. A multivariable logistic regression analysis showed that patients on acenocoumarol had more comorbidities (i.e., ≥3, odds ratio (OR) 1.443, 95% confidence interval (CI) 1.081–1.927, <i>p</i> = 0.013). The mean TiTR was lower in the acenocoumarol than in the warfarin group (56.1 ± 19.2% vs. 61.6 ± 19.4%, <i>p</i> < 0.001). A higher prevalence of TiTR (<60%, <65%, or <70%) was found in acenocoumarol users than in warfarin ones (<i>p</i> < 0.001 for all comparisons). Acenocoumarol use was associated with low TiTR regardless of the cutoff used at multivariable analysis. A lower TiTR on acenocoumarol was found in all subgroups of patients analyzed according to sex, hypertension, diabetes, age, valve site, atrial fibrillation, and INR range. In conclusion, anticoagulation quality was consistently lower in MPHV patients on acenocoumarol compared to those on warfarin.https://www.mdpi.com/1420-3049/26/5/1425warfarinacenocoumarolmechanical valvetime in therapeutic rangeanticoagulation |
| spellingShingle | Danilo Menichelli Daniela Poli Emilia Antonucci Vittoria Cammisotto Sophie Testa Pasquale Pignatelli Gualtiero Palareti Daniele Pastori the Italian Federation of Anticoagulation Clinics (FCSA) Comparison of Anticoagulation Quality between Acenocoumarol and Warfarin in Patients with Mechanical Prosthetic Heart Valves: Insights from the Nationwide PLECTRUM Study Molecules warfarin acenocoumarol mechanical valve time in therapeutic range anticoagulation |
| title | Comparison of Anticoagulation Quality between Acenocoumarol and Warfarin in Patients with Mechanical Prosthetic Heart Valves: Insights from the Nationwide PLECTRUM Study |
| title_full | Comparison of Anticoagulation Quality between Acenocoumarol and Warfarin in Patients with Mechanical Prosthetic Heart Valves: Insights from the Nationwide PLECTRUM Study |
| title_fullStr | Comparison of Anticoagulation Quality between Acenocoumarol and Warfarin in Patients with Mechanical Prosthetic Heart Valves: Insights from the Nationwide PLECTRUM Study |
| title_full_unstemmed | Comparison of Anticoagulation Quality between Acenocoumarol and Warfarin in Patients with Mechanical Prosthetic Heart Valves: Insights from the Nationwide PLECTRUM Study |
| title_short | Comparison of Anticoagulation Quality between Acenocoumarol and Warfarin in Patients with Mechanical Prosthetic Heart Valves: Insights from the Nationwide PLECTRUM Study |
| title_sort | comparison of anticoagulation quality between acenocoumarol and warfarin in patients with mechanical prosthetic heart valves insights from the nationwide plectrum study |
| topic | warfarin acenocoumarol mechanical valve time in therapeutic range anticoagulation |
| url | https://www.mdpi.com/1420-3049/26/5/1425 |
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