Management of anticoagulation with vitamin K antagonists in a tertiary hospital outpatient clinic

Introduction: atrial fibrillation (AF) is one of the main risk factors for stroke. Vitamin K antagonists (VKA) reduce this risk, and the effectiveness of this treatment is directly related to time in therapeutic range (TTR). This study aimed to report the TTR in patients with non-valvular AF at an a...

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Main Authors: Fernando Pivatto Júnior, André Luis Ferreira da Silva, Bárbara Bárbara Marina Simionato, Fernanda Fuzinatto, Jerônimo De Conto Oliveira, Leonardo Martins Pires, Roberta Cristina Petry, Rafael Selbach Scheffel, Luís Carlos Amon
Format: Article
Language:English
Published: Hospital de Clinicas de Porto Alegre ; Universidade Federal do Rio Grande do Sul (UFRGS) 2014-06-01
Series:Clinical and Biomedical Research
Subjects:
Online Access:http://seer.ufrgs.br/index.php/hcpa/article/view/44802
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author Fernando Pivatto Júnior
André Luis Ferreira da Silva
Bárbara Bárbara Marina Simionato
Fernanda Fuzinatto
Jerônimo De Conto Oliveira
Leonardo Martins Pires
Roberta Cristina Petry
Rafael Selbach Scheffel
Luís Carlos Amon
author_facet Fernando Pivatto Júnior
André Luis Ferreira da Silva
Bárbara Bárbara Marina Simionato
Fernanda Fuzinatto
Jerônimo De Conto Oliveira
Leonardo Martins Pires
Roberta Cristina Petry
Rafael Selbach Scheffel
Luís Carlos Amon
author_sort Fernando Pivatto Júnior
collection DOAJ
description Introduction: atrial fibrillation (AF) is one of the main risk factors for stroke. Vitamin K antagonists (VKA) reduce this risk, and the effectiveness of this treatment is directly related to time in therapeutic range (TTR). This study aimed to report the TTR in patients with non-valvular AF at an anticoagulation outpatient clinic; and to describe the profile of this population of patients in terms of risk of stroke, as well as the occurrence of adverse events during the follow-up. Methods: Retrospective cohort study involving patients of the anticoagulation outpatient clinic of the Department of Internal Medicine at Hospital de Clínicas de Porto Alegre. We evaluated outpatient visits, hospital admissions, and emergency visits from January to December 2011. TTR was calculated using the Rosendaal method. Results: Sixty-three patients were investigated. Their mean age was 74.3±10.9 years. The CHADS2 score was ≥ 4 in 44.5% of the patients; 63.5% of them had a CHA2DS2-VASc score ≥ 5. The TTR was 64.8%. During follow-up, the incidence of overall bleeding was 31.7%, with major and minor bleeding rates of 4.8% and 34.9%, respectively. There were no other complications related to AF or anticoagulation. Conclusion: The patients achieved a TTR of 64.8% during follow-up, which is deemed appropriate and in agreement with the literature. Patients had high risk for stroke, and the incidence of minor bleeding was higher than the rate found in the literature, whereas the incidence of major bleeding was similar to the one found in previous studies.
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spelling doaj.art-bf2320627b73482295888780c4f634552022-12-21T20:31:04ZengHospital de Clinicas de Porto Alegre ; Universidade Federal do Rio Grande do Sul (UFRGS)Clinical and Biomedical Research0101-55752357-97302014-06-0134224385Management of anticoagulation with vitamin K antagonists in a tertiary hospital outpatient clinicFernando Pivatto JúniorAndré Luis Ferreira da SilvaBárbara Bárbara Marina SimionatoFernanda FuzinattoJerônimo De Conto OliveiraLeonardo Martins PiresRoberta Cristina PetryRafael Selbach ScheffelLuís Carlos AmonIntroduction: atrial fibrillation (AF) is one of the main risk factors for stroke. Vitamin K antagonists (VKA) reduce this risk, and the effectiveness of this treatment is directly related to time in therapeutic range (TTR). This study aimed to report the TTR in patients with non-valvular AF at an anticoagulation outpatient clinic; and to describe the profile of this population of patients in terms of risk of stroke, as well as the occurrence of adverse events during the follow-up. Methods: Retrospective cohort study involving patients of the anticoagulation outpatient clinic of the Department of Internal Medicine at Hospital de Clínicas de Porto Alegre. We evaluated outpatient visits, hospital admissions, and emergency visits from January to December 2011. TTR was calculated using the Rosendaal method. Results: Sixty-three patients were investigated. Their mean age was 74.3±10.9 years. The CHADS2 score was ≥ 4 in 44.5% of the patients; 63.5% of them had a CHA2DS2-VASc score ≥ 5. The TTR was 64.8%. During follow-up, the incidence of overall bleeding was 31.7%, with major and minor bleeding rates of 4.8% and 34.9%, respectively. There were no other complications related to AF or anticoagulation. Conclusion: The patients achieved a TTR of 64.8% during follow-up, which is deemed appropriate and in agreement with the literature. Patients had high risk for stroke, and the incidence of minor bleeding was higher than the rate found in the literature, whereas the incidence of major bleeding was similar to the one found in previous studies.http://seer.ufrgs.br/index.php/hcpa/article/view/44802Anticoagulantswarfarinphenprocoumonatrial fibrillationinternship and residency
spellingShingle Fernando Pivatto Júnior
André Luis Ferreira da Silva
Bárbara Bárbara Marina Simionato
Fernanda Fuzinatto
Jerônimo De Conto Oliveira
Leonardo Martins Pires
Roberta Cristina Petry
Rafael Selbach Scheffel
Luís Carlos Amon
Management of anticoagulation with vitamin K antagonists in a tertiary hospital outpatient clinic
Clinical and Biomedical Research
Anticoagulants
warfarin
phenprocoumon
atrial fibrillation
internship and residency
title Management of anticoagulation with vitamin K antagonists in a tertiary hospital outpatient clinic
title_full Management of anticoagulation with vitamin K antagonists in a tertiary hospital outpatient clinic
title_fullStr Management of anticoagulation with vitamin K antagonists in a tertiary hospital outpatient clinic
title_full_unstemmed Management of anticoagulation with vitamin K antagonists in a tertiary hospital outpatient clinic
title_short Management of anticoagulation with vitamin K antagonists in a tertiary hospital outpatient clinic
title_sort management of anticoagulation with vitamin k antagonists in a tertiary hospital outpatient clinic
topic Anticoagulants
warfarin
phenprocoumon
atrial fibrillation
internship and residency
url http://seer.ufrgs.br/index.php/hcpa/article/view/44802
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