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Revista Cubana de Hematología, Inmunología y Hemoterapia

On-line version ISSN 1561-2996

Abstract

MARTIN ENGUIX, David et al. Evolution of the degree of control in a cohort of anticoagulated patients in Primary Care. Rev Cubana Hematol Inmunol Hemoter [online]. 2021, vol.37, n.4  Epub Dec 01, 2021. ISSN 1561-2996.

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.

Keywords : primary health care; anticoagulants; INR control degree.

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