RESUMO
We analyzed documentation of 648 outpatients with nonvalvular atrial fibrillation receiving ambulatory care in 3 cities in Russia (Moscow, Krasnodar, and Bryansk). Frequency of use of any anticoagulant in patients with AF and high risk of stroke and systemic embolism was low (30.9% overall, novel oral anticoagulants--5.7%). But portions of patients who according to documents received antiaggregants or no antithrombotic drugs at all were high (53.6 and 13.4%, respectively). Among patients receiving warfarin only 19.6% checked international normalized ratio (INR) every month while 75% did it once in 3 months or rarer or did not control this parameter at all. Among patients in whom INR control was sufficiently regular only in 44% percentage of time in the therapeutic range exceeded 60%. Thus persistent effective anticoagulation was achieved only in 12.6% of warfarin treated outpatients.
Assuntos
Assistência Ambulatorial/métodos , Fibrilação Atrial/complicações , Prescrições de Medicamentos/normas , Controle de Medicamentos e Entorpecentes/métodos , Fibrinolíticos/administração & dosagem , Pacientes Ambulatoriais , Trombose/prevenção & controle , Administração Oral , Idoso , Fibrilação Atrial/tratamento farmacológico , Feminino , Seguimentos , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Federação Russa , Trombose/etiologiaRESUMO
We analyzed documentation of 648 outpatients with nonvalvular atrial fibrillation receiving ambulatory care in 3 cities in Russia (Moscow, Krasnodar, and Bryansk). Frequency of use of any anticoagulant in patients with AF and high risk of stroke and systemic embolism was low (30.9% overall, novel oral anticoagulants - 5.7%). But portions of patients who according to documents received antiaggregants or no antithrombotic drugs at all were high (53.6 and 13.4%, respectively). Among patients receiving warfarin only 19.6% checked international normalized ratio (INR) every month while 75% did it once in 3 months or rarer or did not control this parameter at all. Among patients in whom INR control was sufficiently regular only in 44% percentage of time in the therapeutic range exceeded 60%. Thus persistent effective anticoagulation was achieved only in 12.6% of warfarin treated outpatients.
