Factores asociados a la anticoagulación oral óptima en el adulto mayor con fibrilación auricular

Gamero, Maria T; Cornejo, M García; Dueñas, Roy; Samalvides, Frine

doi:10.20453/rmh.v28i2.3108

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…12 Previous investigations on factors associated with anticoagulation control have shown a relationship between TTR and sex, albeit with conflicting evidence. Some authors reported an association of females with poorer TTR, although others found poorer TTR in men [13][14][15] or no association of oral anticoagulation control with sex. 16,17 Sex-related aspects that may affect TTR, such as behavioural and physiological factors, are not fully understood.…”

Section: Introductionmentioning

confidence: 99%

Sex‐influence on the time in therapeutic range (TTR) during oral anticoagulation with coumarin derivatives: Systematic review and meta‐analysis

Viana

Praxedes

Sousa

et al. 2021

Brit J Clinical Pharma

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Aims: We sought to investigate the association between sex and oral anticoagulation control employing coumarin derivatives.Methods: Electronic sources were MEDLINE, Biblioteca Virtual em Saúde (BVS), The Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Cochrane Central and Web of Science. Inclusion criteria were: observational and experimental studies; age ≥18 years; both sexes; treatment with any coumarin derivative for ≥3 months; any indication of long-term use; quality of oral anticoagulation measured by time in therapeutic range (TTR). The meta-analysis was developed with odds ratios (OR) for binary variables and mean differences (MD) for continuous variables, using random-effects models (DerSimonian and Laird) with 95% confidence intervals (CI).Results: Overall, 22 articles were selected, comprising 16 cohort studies, four crosssectional studies and two clinical trials. The number of participants ranged from 110 to 104 505 (183 612; women: 45%). The main indication of oral anticoagulation was atrial fibrillation. Most studies reported the use of warfarin. In the meta-analysis, 15 studies were analysed using TTR as a binary variable (OR = 0.87; 95% CI = 0.78, 0.96; z = À2.75; P = .006.; I 2 = 67%) and seven studies as a continuous variable (MD = À2.97; 95% CI = À4.80, À1.14; z = À3.19; P = .0014; I 2 = 75%). The pooled estimates indicated that women were associated with lower TTR than men.Conclusions: Our findings revealed an association between female sex and worse oral anticoagulation control. Further studies are needed with primary design to investigate sex-related factors influencing oral anticoagulation control with coumarin derivatives. Innovative strategies focused on women's health may be useful to improve patient-centred care.

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Section: Introductionmentioning

confidence: 99%

Sex‐influence on the time in therapeutic range (TTR) during oral anticoagulation with coumarin derivatives: Systematic review and meta‐analysis

Viana

Praxedes

Sousa

et al. 2021

Brit J Clinical Pharma

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“…Studies about the use of anticoagulants in Latin America confirm this information. Gamero et al, in a study performed in Peru in 2017, found that 95% of people with oral anticoagulation received warfarin and only 5% took direct oral anticoagulants, attributing this phenomenon to a subject of costs (29).…”

Section: Discussionmentioning

confidence: 99%

Profile and clinical indicators of an anticoagulation domiciliary program in Bogota.

Leal

Martínez

Cubillo

2019

Rev. cienc. cuidad.

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Objective: Describe the profile and clinical indicators of people from a domiciliary anticoagulation program in the city of Bogota, during a year of monitoring. Materials and methods: Quantitative study of descriptive scope. The population was made of 66 people from the program, who met the inclusion criteria and were cared for a year. Some of the measured variables were: type of anticoagulant, anticoagulation indications, functional compromise, risk of bleeding and time in therapeutic range. The information was obtained from monthly statistics from the program, univariate analyzed, reporting frequency distributions and ethical aspects were protected for the health research. Results: 66 patients older than 60 years of age that received Warfarin were attended and the main symptom was atrial fibrillation. The patients reached the therapeutic target in the first 9 days, achieving 70% of time in the therapeutic range, and no adverse events were presented although being at intermediate-high risk of bleeding, severe functional detriment and high comorbidity. Conclusion: The permanent monitoring of coagulation time, availability of additional controls, fast adjustments in the anticoagulation doses, health education and a direct communication channel between the patient, the family, and the healthcare team, could improve the clinical indicators of anticoagulated patients.

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“…(5) La prevalencia de la FA se multiplica con la edad, es por tanto, un problema sanitario muy relevante a nivel poblacional, esto se debe no solo a su alta prevalencia e incidencia, sino también por los elevados costos que se derivan de las complicaciones que conlleva. (3,6) El ictus isquémico es la complicación más importante, con un riesgo relativo (RR) 2-7 veces mayor que el de los pacientes sin FA. El incremento del riesgo de hemorragia, especialmente la temida hemorragia intracraneal, acompaña al tratamiento con anticoagulantes orales.…”

Section: Introductionunclassified

Thromboembolic and hemorrhagic risk in permanent nonvalvular atrial fibrillation

Echevarría-Cruz¹,

Gracia-Peña²,

López

et al. 2022

Salud, Ciencia y Tecnología

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Introducción: la fibrilación auricular es la arritmia cardiaca más frecuente en la práctica clínica diaria, se asocia a un marcado aumento del riesgo de accidentes tromboembólicos. Objetivo: Caracterizar el riego tromboembólico y hemorrágico en los pacientes con fibrilación auricular no valvular permanente.Método: se realizó una investigación observacional, descriptiva y transversal en el Hospital General Docente “Abel Santamaría Cuadrado” de Pinar del Río durante el período comprendido entre julio 2019 y julio 2021. Se trabajó con la totalidad del universo y estuvo constituido por 92 pacientes.Resultados: la incidencia de fibrilación auricular se incrementó a medida que lo hizo la edad, el sexo masculino represento el 64,2 % de la muestra. El 60,86 % presentó riesgo tromboembólico elevado. En cuanto a factores de riesgo, el 68,4 % fue mayor de 65 años, el 61 % de los pacientes presentó riego elevado de hemorragia (53,26 %), se mantuvo un predominio de anticoagulantes orales tanto en pacientes con riego elevado de hemorragia así como en los de bajo riesgo, con un 28,26 % y 31,52 % respectivamente. Conclusiones: los pacientes tuvieron un nivel de riego tromboembólico elevado y recibieron tratamiento anticoagulante. Los factores de riesgo de sangrado más frecuentes fueron la edad, los fármacos y el alcohol. La mayoría de los pacientes presentaron un nivel de riesgo hemorrágico elevado.

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Factores asociados a la anticoagulación oral óptima en el adulto mayor con fibrilación auricular

Cited by 3 publications

References 18 publications

Sex‐influence on the time in therapeutic range (TTR) during oral anticoagulation with coumarin derivatives: Systematic review and meta‐analysis

Sex‐influence on the time in therapeutic range (TTR) during oral anticoagulation with coumarin derivatives: Systematic review and meta‐analysis

Profile and clinical indicators of an anticoagulation domiciliary program in Bogota.

Thromboembolic and hemorrhagic risk in permanent nonvalvular atrial fibrillation

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