Efectividad y seguridad del tratamiento anticoagulante con acenocumarol en fibrilación auricular no valvular

Background: Vitamin K antagonists significantly decrease the incidence of stroke but increase the risk of bleeding. Aim: To assess the effectiveness and risk of bleeding of vitamin K antagonists in non-valvular atrial fibrillation. Material and Methods: Retrospective cohort study of 524 patients,...

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Autores principales:	Castro,Constanza, Bustos,Luis, Ocampo,Renato, Molina,Elda, Cabrero,Pía, Vergara,René, Lanas,Fernando
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2017
Materias:	Acenocoumarol Anticoagulants Atrial Fibrillation Hemorrhage Stroke
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017001001243
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spelling	oai:scielo:S0034-988720170010012432018-02-16Efectividad y seguridad del tratamiento anticoagulante con acenocumarol en fibrilación auricular no valvularCastro,ConstanzaBustos,LuisOcampo,RenatoMolina,EldaCabrero,PíaVergara,RenéLanas,Fernando Acenocoumarol Anticoagulants Atrial Fibrillation Hemorrhage Stroke Background: Vitamin K antagonists significantly decrease the incidence of stroke but increase the risk of bleeding. Aim: To assess the effectiveness and risk of bleeding of vitamin K antagonists in non-valvular atrial fibrillation. Material and Methods: Retrospective cohort study of 524 patients, 236 women (45%) and 288 men (55%) with non-valvular atrial fibrillation (NVAF) admitted to the oral anticoagulation treatment (OAT) clinic at four public hospitals, between 2009 and 2012. They were followed until March 2013, measuring the quality of OAT, ischemic and bleeding events. Results: The mean follow-up was 26.1 months, with 1,154.7 person-years of follow-up accrued. The percentage of time in therapeutic range (TTR) was 35.2 ± 18%; this was deemed to represent the quality of OAT. The cumulative incidence of ischemic events, either stroke or systemic embolism, was 2.25/100 person-years, being greater in patients with previous embolism (Risk ratio 5.21, 95% confidence intervals 2.31– 11.73, p < 0.01). The cumulative incidence of major bleeding events-extracranial and intracraneal-was 4.08/100 person-years. The main site of extracranial major bleeding was the gastrointestinal tract (32%). Conclusions: In our clinical practice, the effectiveness of OAT with acenocoumarol in NVAF patients is similar to that published abroad. However, the incidence of bleeding complications is higher. The quality of the OAT measured by the TTR was lower than abroad.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.145 n.10 20172017-10-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017001001243es10.4067/S0034-98872017001001243
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Acenocoumarol Anticoagulants Atrial Fibrillation Hemorrhage Stroke
spellingShingle	Acenocoumarol Anticoagulants Atrial Fibrillation Hemorrhage Stroke Castro,Constanza Bustos,Luis Ocampo,Renato Molina,Elda Cabrero,Pía Vergara,René Lanas,Fernando Efectividad y seguridad del tratamiento anticoagulante con acenocumarol en fibrilación auricular no valvular
description	Background: Vitamin K antagonists significantly decrease the incidence of stroke but increase the risk of bleeding. Aim: To assess the effectiveness and risk of bleeding of vitamin K antagonists in non-valvular atrial fibrillation. Material and Methods: Retrospective cohort study of 524 patients, 236 women (45%) and 288 men (55%) with non-valvular atrial fibrillation (NVAF) admitted to the oral anticoagulation treatment (OAT) clinic at four public hospitals, between 2009 and 2012. They were followed until March 2013, measuring the quality of OAT, ischemic and bleeding events. Results: The mean follow-up was 26.1 months, with 1,154.7 person-years of follow-up accrued. The percentage of time in therapeutic range (TTR) was 35.2 ± 18%; this was deemed to represent the quality of OAT. The cumulative incidence of ischemic events, either stroke or systemic embolism, was 2.25/100 person-years, being greater in patients with previous embolism (Risk ratio 5.21, 95% confidence intervals 2.31– 11.73, p < 0.01). The cumulative incidence of major bleeding events-extracranial and intracraneal-was 4.08/100 person-years. The main site of extracranial major bleeding was the gastrointestinal tract (32%). Conclusions: In our clinical practice, the effectiveness of OAT with acenocoumarol in NVAF patients is similar to that published abroad. However, the incidence of bleeding complications is higher. The quality of the OAT measured by the TTR was lower than abroad.
author	Castro,Constanza Bustos,Luis Ocampo,Renato Molina,Elda Cabrero,Pía Vergara,René Lanas,Fernando
author_facet	Castro,Constanza Bustos,Luis Ocampo,Renato Molina,Elda Cabrero,Pía Vergara,René Lanas,Fernando
author_sort	Castro,Constanza
title	Efectividad y seguridad del tratamiento anticoagulante con acenocumarol en fibrilación auricular no valvular
title_short	Efectividad y seguridad del tratamiento anticoagulante con acenocumarol en fibrilación auricular no valvular
title_full	Efectividad y seguridad del tratamiento anticoagulante con acenocumarol en fibrilación auricular no valvular
title_fullStr	Efectividad y seguridad del tratamiento anticoagulante con acenocumarol en fibrilación auricular no valvular
title_full_unstemmed	Efectividad y seguridad del tratamiento anticoagulante con acenocumarol en fibrilación auricular no valvular
title_sort	efectividad y seguridad del tratamiento anticoagulante con acenocumarol en fibrilación auricular no valvular
publisher	Sociedad Médica de Santiago
publishDate	2017
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017001001243
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Efectividad y seguridad del tratamiento anticoagulante con acenocumarol en fibrilación auricular no valvular

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