Caldeira D, Cruz I, Morgado G, Stuart B, Gomes C, Martins C, João I, Pereira H. Evaluation of time in therapeutic range in anticoagulated patients: a single-center, retrospective, observational study.
BMC Res Notes 2014;
7:891. [PMID:
25491419 PMCID:
PMC4295272 DOI:
10.1186/1756-0500-7-891]
[Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 11/28/2014] [Indexed: 11/17/2022] Open
Abstract
Background
The percentage of time during which the patients have the INR within the target values (i.e. Time in Therapeutic Range [TTR]) is a measure of anticoagulation quality with Vitamin K Antagonists (VKA). To evaluate the quality of anticoagulation using TTR according to the Rosendaal method, we performed an observational, retrospective study. We included all outpatients who attended the cardiology anticoagulation clinic of a Portuguese hospital (2011–2013), whose target INR was 2.0-3.0.
Results
377 VKA-treated patients were evaluated. Of these, 72.4% had non-valvular atrial fibrillation. Patients were followed for a mean period of 471 days. The mean TTR was 60.3% (SD 19.3%) and 44.3% of the patients had a mean TTR < 60%. Patients were at high risk of bleeding (INR > 4.5) and at high thrombotic risk (INR < 1.5) during, respectively, 1.7% and 4.7% of the time.
Conclusions
Anticoagulation control needs to be improved. These results are informative for all stakeholders: patients, health care professionals, and policymakers.
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