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Estado de control de pacientes en tratamiento con anticoagulantes orales antagonistas de la vitaminaK en atención primaria. Estudio ECOPAVIK / Update on the control of patients on treatment with vitaminK antagonist oral anticoagulants in Primary Care
Fernández López, P; López Ramiro, MI; Merino de Haro, I; Cedeño Manzano, G; Díaz Siles, FJ; Hermoso Sabio, A.
Affiliation
  • Fernández López, P; Zona Básica de Salud de La Zubia. La Zubia. España
  • López Ramiro, MI; Zona Básica de Salud de La Zubia. La Zubia. España
  • Merino de Haro, I; Zona Básica de Salud de La Zubia. La Zubia. España
  • Cedeño Manzano, G; Zona Básica de Salud de La Zubia. La Zubia. España
  • Díaz Siles, FJ; Zona Básica de Salud de La Zubia. La Zubia. España
  • Hermoso Sabio, A; Zona Básica de Salud de La Zubia. La Zubia. España
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 42(8): 530-537, nov.-dic. 2016. tab, graf
Article in Spanish | IBECS | ID: ibc-157885
Responsible library: ES1.1
Localization: BNCS
RESUMEN
Introducción. En España, más del 80% de pacientes con fibrilación auricular (FA) reciben tratamiento anticoagulante oral (TAO), con un seguimiento dentro del ámbito de la atención primaria (AP) del 72% de los pacientes. Estudios recientes demuestran que existe un deficiente control de los pacientes con anticoagulantes orales (ACO). El objetivo de este estudio fue obtener un conocimiento más detallado del estado de control, así como de las patologías que lo indican y están en comorbilidad en los pacientes en tratamiento con ACO antagonistas de la vitaminaK (AVK). Metodología. Estudio observacional retrospectivo/transversal en el que participaron pacientes de una zona básica de salud incluidos dentro del programa TAO durante 2014. Se consideró que el control de INR en pacientes en tratamiento con ACO era inadecuado cuando el porcentaje de tiempo en rango terapéutico (TRT) era inferior al 65% durante un periodo de valoración de al menos 6meses. Resultados. Se incluyeron 368 pacientes, en los que la patología con indicación de anticoagulación oral más prevalente fue la FA no valvular. Se realizaron 5.128 controles, de los cuales 2.359 (46%) estaban fuera de rango terapéutico y 2.769 (54%) estaban en rango terapéutico. El 91% de los pacientes en tratamiento con ACO AVK presentaban un riesgo muy elevado de tromboembolismo. Conclusiones. La indicación de anticoagulación en nuestra población es correcta, asumiendo un riesgo hemorrágico bajo/intermedio en la mayoría de los pacientes. La medición del TRT mediante el método de Rosendaal indica que existe un deficiente control de los pacientes en tratamiento con ACO AVK (AU)
ABSTRACT
Background. In Spain, more than 80% of patients with atrial fibrillation (AF) receive oral anticoagulant therapy (OAT), and 72% of these patients are followed up in the Primary Care (PC) setting. Recent studies have shown that there is insufficient control of patients on OAT. The objective of the present study was to obtain more detailed information on the state of control of patients on treatment with vitaminK antagonist (VKA) oral anticoagulants (OAC), on the diseases for which the therapy was indicated and on concomitant diseases. Methods. This was a retrospective, cross-sectional, observational study with the participation of patients from a single health area included in an OAT programme throughout 2014. In patients on treatment with OAC, International Normalised Ratio (INR) control was considered insufficient when the percentage time in therapeutic range (TTR) was below 65% during an evaluation period of at least 6months. Results. A total of 368 patients were included in the study, where the most frequent indication for oral anticoagulation was non-valvular AF. A total of 5,128 INR controls were performed, of which 2,359 (46%) were outside the therapeutic range, and 2,769 (54%) were within range. The risk of thromboembolism was very high in 91% of patients on treatment with VKA OAC. Conclusions. The indication for anticoagulation is correct in our population, assuming a low-intermediate risk of haemorrhage in the majority of patients. Measurement of the TTR using the Rosendaal method shows that the control of patients on treatment with VKA OAC is insufficient (AU)
Subject(s)

Full text: Available Collection: National databases / Spain Health context: SDG3 - Target 3.8 Achieve universal access to health / Sustainable Health Agenda for the Americas / SDG3 - Health and Well-Being Health problem: Delivery Arrangements / Goal 9: Noncommunicable diseases and mental health / Target 3.4: Reduce premature mortality due to noncommunicable diseases / Target 3.9: Reduce the amount of deaths produced by dangerous chemicals and the pollution of the air, water and soil Database: IBECS Main subject: Atrial Fibrillation / Thromboembolism / Vitamin K / Health Surveillance / Health Care Coordination and Monitoring / Anticoagulants Type of study: Observational study / Prevalence study / Risk factors / Screening study Limits: Female / Humans / Male Language: Spanish Journal: SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) Year: 2016 Document type: Article Institution/Affiliation country: Zona Básica de Salud de La Zubia/España

Full text: Available Collection: National databases / Spain Health context: SDG3 - Target 3.8 Achieve universal access to health / Sustainable Health Agenda for the Americas / SDG3 - Health and Well-Being Health problem: Delivery Arrangements / Goal 9: Noncommunicable diseases and mental health / Target 3.4: Reduce premature mortality due to noncommunicable diseases / Target 3.9: Reduce the amount of deaths produced by dangerous chemicals and the pollution of the air, water and soil Database: IBECS Main subject: Atrial Fibrillation / Thromboembolism / Vitamin K / Health Surveillance / Health Care Coordination and Monitoring / Anticoagulants Type of study: Observational study / Prevalence study / Risk factors / Screening study Limits: Female / Humans / Male Language: Spanish Journal: SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) Year: 2016 Document type: Article Institution/Affiliation country: Zona Básica de Salud de La Zubia/España
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