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2021, Number 4

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Rev Cubana Hematol Inmunol Hemoter 2021; 37 (4)

Evolution of the degree of control in a cohort of anticoagulated patients in Primary Care

Martín ED, Hidalgo RA, Aguirre RJC, Sánchez CM, Lacorzana J

Language: Spanish
References: 29
Page: 1-19
PDF size: 436.01 Kb.


ABSTRACT

Introduction: Only 60% of patients on treatment with vitamin K antagonists (AVK) are controlled.
Objectives: We proposed to analyze a cohort of anticoagulated patients to assess their degree of control and their evolution at 2 years, after a brief training intervention.
Methods: Longitudinal, observational, retrospective study of 157 anticoagulated with AVK. Sociodemographic data, comorbidities, reason for VKA prescription and degree of baseline control were collected and after 2 years of follow-up. We use 2 different valuation methods: Rosendaal and direct method (INR percentage -International Normalized Ratio- in range). Likewise, we established intra-method temporal correlations.
Results: The degree of control went from 47.3% to 53.5% at 2 years, according to Rosendaal (p = 0.52), and from 39.5% to 53.5% according to the direct method (p<0.05). The time in the therapeutic range was 63.1±19.9% at the start and 65±19.2% at the end of the follow-up. The correlation between the 2 controls was positive for both methods (Rosendaal: 0.23; direct method:0.33). The multivariate analysis was significant for males and for a target other than 2.5-3.5(odds ratio: 2.22 and 2.73, respectively).
Conclusions: INR control improved after 2 years of follow-up after training activity. The evolution of the degree of control of each patient is partially predictable. The worst control was associated with female sex and the INR goal of 2.5-3.5. Control improves 2.22 times in males and 2.73 times in those without a target INR of 2.5-3.5.


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