Gómez-Rosas P, Sosa-Velázquez MÁ, Yáñez-Funes LA, González-Trejo JJ, Majluf-Cruz K, Isordia-Salas I, Ignacio-Ibarra G, Almaraz-Delgado M, Moreno-Ruiz LA, Valencia-Chávez JS, Hernández-Juárez J, Vázquez-Rubiel D, Domínguez-Reyes V, Arreola-Díaz R, García-Lee MT, Vela-Ojeda J, Majluf-Cruz A. Analysis of the quality of anticoagulation with vitamin K antagonists in three clinical scenarios in Mexico.
GAC MED MEX 2021;
157:284-292. [PMID:
34667316 DOI:
10.24875/gmm.m21000559]
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Abstract
INTRODUCTION
Vitamin K antagonists (VKA) are a therapeutic alternative in patients with venous thromboembolic disease; however, numerous factors affect their pharmacology.
OBJECTIVE
To evaluate the quality of VKA anticoagulation at three different time periods in Mexico.
METHODS
Prospective study, nested in patient cohorts at three different clinical scenarios between 2013 and 2019. Outpatients with indication for treatment with VKAs for at least 12 months were included. Patients were managed according to the criteria of the treating physician.
RESULTS
Patient general characteristics were similar between groups, except for the VKA indication. The results of 4,148 patients and 38,548 INR assessments were analyzed. The times in therapeutic range during the three phases of the study and pooled data were significantly higher for the anticoagulation clinic. Only the number of patient visits was significantly associated with the results, unlike age, gender, and type of VKA.
CONCLUSIONS
VKAs are widely used, but it is difficult for therapeutic goals to be achieved, especially in non-specialized clinical services. Creation of anticoagulation clinics is an urgent need for the Mexican health system.
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