Experience of Anticoagulant Clinic’s Work in Arkhangelsk

Abstract

It is known that use of indirect anticoagulants (IAC) is the main method of treatment and prevention of thrombosis and thromboembolism in patients. Bleeding is the most important and dangerous complication of treatment with indirect anticoagulants. The incidence of bleeding during treatment IAC is 0.9 to 2.7 %, fatal bleeding constitutes 0.07 to 0.7 %, and hemorrhagic strokes account for 2 % of all bleeding. Therefore, the aim of our study was to evaluate quality of therapy with indirect anticoagulants of patients observed in the Northern Branch of the Hematology Research Center (HRC) in Arkhangelsk. According to the results of our study, frequency of hemorrhagic complications (GC) against long-term treatment of NAC was 7.8 % (95 % CI: 7.8 - 9.4) (n = 94), fatal bleeding as a hemorrhagic stroke constituted 0.1 % during 2.5 years of observation. The number of patients who achieved therapeutic hypocoagulation exceeded 60 % (n = 721). Such factors as taking Cordarone (p = 0.019), use of generic coumadin Russia (p = 0.05), ambulatory monitoring of the international normalized ratio (INR) (p = 0.028) as well as dosages of NAC influenced hemorrhage progression statistically significantly, the main factors reflected in bleeding and level of anticoagulation (INR less than 1.6) were the dose of NAC (p = 0.004) as well as control of the INR (p = 0.001). Taking into account the main factors influencing the level of anticoagulation, it is possible to reduce the number of bleeding cases and prediction of NAC doses. This approach will improve commitment to the NAC therapy of different specialists and enhance quality of patients’ life.