Quality of Oral Anticoagulation in Atrial Fibrillation Patients at a Tertiary Hospital in Brazil

Página do item simplificado
dc.contributor.authorMalagutte, Karina Nogueira Dias Secco [UNESP]
dc.contributor.authorda Silveira, Caroline Ferreira da Silva Mazeto Pupo [UNESP]
dc.contributor.authorReis, Fabrício Moreira [UNESP]
dc.contributor.authorRossi, Daniele Andreza Antonelli [UNESP]
dc.contributor.authorHueb, João Carlos [UNESP]
dc.contributor.authorOkoshi, Katashi [UNESP]
dc.contributor.authorNunes, Hélio Rubens de Carvalho [UNESP]
dc.contributor.authorMartin, Luis Cuadrado [UNESP]
dc.contributor.authorBazan, Rodrigo [UNESP]
dc.contributor.authorBazan, Silméia Garcia Zanati [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.date.accessioned2023-03-02T12:25:26Z
dc.date.available2023-03-02T12:25:26Z
dc.date.issued2022-01-01
dc.description.abstractBackground: Atrial fibrillation (AF) affects 0.5% to 2.0% of the general population and is usually associated with cardiac structural diseases, hemodynamic damage, and thromboembolic complications. Oral anticoagulation prevents thromboembolic events and is monitored by the international normalized ratio (INR). Objectives To evaluate INR stability in nonvalvular AF patients treated with warfarin anticoagulation, to evaluate thromboembolic or hemorrhagic complications, and to identify the group at higher risk for thromboembolic or hemorrhagic events. Methods: Data from the medical records of 203 patients who received medical care at a tertiary hospital in Brazil were reviewed, and the time in therapeutic range (TTR) was calculated using the Rosendaal method. The possible TTR influencing factors were then analyzed, and the relationship between the TTR and thromboembolic or hemorrhagic events was calculated. The level of significance was 5%. Results: The mean TTR was 52.2%. Patients with INR instability in the adaptation phase had a lower mean TTR (46.8%) than those without instability (53.9%). Among the studied patients, 6.9% suffered hemorrhagic events, and 8.4% had a stroke. The higher risk group for stroke and bleeding consisted of patients with INR instability in the adaptation phase. Conclusions: The quality of anticoagulation in this tertiary hospital in Brazil is similar to that in centers in developing countries. Patients with greater INR instability in the adaptation phase evolved to a lower mean TTR during follow-up, had a 4.94-fold greater chance of stroke, and had a 3.35-fold greater chance of bleeding. Thus, for this patient group, individualizing the choice of anticoagulation therapy would be advised, considering the cost-benefit ratio.en
dc.description.affiliationUniversidade Estadual Paulista Júlio de Mesquita, SP
dc.description.affiliationUnespUniversidade Estadual Paulista Júlio de Mesquita, SP
dc.format.extent363-369
dc.identifierhttp://dx.doi.org/10.36660/abc.20210805
dc.identifier.citationArquivos Brasileiros de Cardiologia, v. 119, n. 3, p. 363-369, 2022.
dc.identifier.doi10.36660/abc.20210805
dc.identifier.issn1678-4170
dc.identifier.issn0066-782X
dc.identifier.scopus2-s2.0-85137353904
dc.identifier.urihttp://hdl.handle.net/11449/242246
dc.language.isoeng
dc.relation.ispartofArquivos Brasileiros de Cardiologia
dc.sourceScopus
dc.subjectAtrial Fibrillation
dc.subjectHemorrhage
dc.subjectStroke
dc.subjectWarfarin
dc.titleQuality of Oral Anticoagulation in Atrial Fibrillation Patients at a Tertiary Hospital in Brazilen
dc.typeArtigo

Arquivos

Coleções

Artigos - Clínica Médica - FMB
Artigos - Neurologia, Psicologia e Psiquiatria - FMB