Chávez-Torres R, Elizalde-Barrera CI, Barragán-Jiménez Z, Huerta-Ramírez S

Language: Spanish
References: 14
Page: 135-141
PDF size: 268.10 Kb.

ABSTRACT

Background: The annual incidence of deep vein thrombosis is 0.1% and increases to 1% over Age 60. Recurrence of the disease per year is 5 to 10%, and is multifactorial in origin. The ideal treatment should bring acenocoumarin INR between 2 and 3 seconds, even though there is a scheme set up to achieve this goal and to decrease the risk of bleeding.
Objective: to determine the most effective dose and for sure acenocoumarin goal INR between 2 and 3 seconds and lower the risk of bleeding in patients with deep vein thrombosis.
Material and Methods: We identified a sample of 55 patients with clinical and Doppler Ultrasound for Deep Vein Thrombosis. With informed consent were randomized into two study groups, group 1 received fixed doses of 4mg acenocoumarin for 5 days (28 patients), group 2 received decreasing doses respectively 8,6,4,4,2 mg for 5 days (27 patients). Serum levels of Hemoglobin, Hematocrit, Platelet count, Albumin, Prothrombin Time (PT), Thromboplastin Time (PTT) and INR at baseline and at the end of treatment. Statistical analysis for comparison of variables between groups was used chi square and Fisher exact test for dichotomous variables, t-student and Mann Whitney U for numerical data. The feel is significant p ‹0.05 and used the STATA statistical program for data analysis.
Results: Of the total sample, 34 were women and 21 men, mean age was 55 +-11years, 13 were diabetics, 32 hypertensive, 19 with smoking, 10 with alcoholism and 45 obese. Albumin levels in group 1 were 3.6 and 3.4 in group 2 (p = 0.016). The final value of TP in-group 1 was 30 and in-group 2 of 40.3 (p = 0.042), INR level end of group 1 was 2.7 + - 0.08 and group 2 of 4.5 + - 0.21 (p = 0.001). In group 1 was obtained which 20 reached the goal of anticoagulation, group 2 only 3 met the goal (p = 0.001). It was observed that the group 2 had bleeding 6 patients, while group 1 not present (p = 0.008)
Conclusions: Patients treated with fixed dose of acenocoumarin reached the target INR with less risk of bleeding. Albumin levels seem to affect the goal of anticoagulation.

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