ARE PATIENTS WITH ATRIAL FIBRILLATION MEDICATED WITH WARFARIN EFFECTIVELY HYPOCOAGULATED? OBSERVATIONAL STUDY IN TWO FAMILY HEALTH UNITS IN THE LISBON REGION.
DOI:
https://doi.org/10.58043/rphrc.2Keywords:
atrial fibrillation, warfarin, TTRAbstract
Atrial fibrillation (AF) is one of the main causes of stroke and one way to reduce the associated risk is through effective anticoagulant therapy, which means maximizing the number of INRs in therapeutic range (TTR) when using warfarin in patients.
This retrospective observational and analytical study aims to assess TTR indicators in patients receiving warfarin for atrial fibrillation under the medical care of two family health units in Lisbon, Portugal, as well as to compare the existence of suboptimal modifiable haemorrhagic risk factors and the number of haemorrhagic and cardiovascular events among patients with good or bad therapeutic control.
In a total of 50 eligible patients, 57,8% had INR values within the therapeutic range and the average TTR value was 57,89%. When it comes to modifiable haemorrhagic risk factors, 22% of the patients had uncontrolled hypertension and 26% had been prescribed with nonsteroidal anti-inflammatory or anti-platelet drugs. In the group with bad therapeutic control, 58% of the patients had haemorrhagic and cardiovascular events (p = 0,288) and 58% had suboptimal modifiable haemorrhagic risk factors (p = 0,845).
This study confirmed a good therapeutic control regarding warfarin use when comparing to other national and international studies in general. However, it showed lower values when comparing the results to other national primary care studies. There was a higher number of haemorrhagic and cardiovascular events and suboptimal modifiable haemorrhagic risk factors in the group with bad therapeutic control, although those numbers were not statistically significant.
This study shows there is still a long way to go when it comes to improving the treatment of AF in patients medicated with warfarin in primary care units. Hence, a broader approach of these patient is needed, in order to reduce their morbimortality.
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