ARE PATIENTS WITH ATRIAL FIBRILLATION MEDICATED WITH WARFARIN EFFECTIVELY HYPOCOAGULATED? OBSERVATIONAL STUDY IN TWO FAMILY HEALTH UNITS IN THE LISBON REGION.
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.58043/rphrc.2 |
Resumo: | Atrial fibrillation (AF) is one of the main causes of stroke and one way to reduce the associated risk is through effective anticoagulant therapy, which means maximizing the number of INRs in therapeutic range (TTR) when using warfarin in patients.This retrospective observational and analytical study aims to assess TTR indicators in patients receiving warfarin for atrial fibrillation under the medical care of two family health units in Lisbon, Portugal, as well as to compare the existence of suboptimal modifiable haemorrhagic risk factors and the number of haemorrhagic and cardiovascular events among patients with good or bad therapeutic control. In a total of 50 eligible patients, 57,8% had INR values within the therapeutic range and the average TTR value was 57,89%. When it comes to modifiable haemorrhagic risk factors, 22% of the patients had uncontrolled hypertension and 26% had been prescribed with nonsteroidal anti-inflammatory or anti-platelet drugs. In the group with bad therapeutic control, 58% of the patients had haemorrhagic and cardiovascular events (p = 0,288) and 58% had suboptimal modifiable haemorrhagic risk factors (p = 0,845). This study confirmed a good therapeutic control regarding warfarin use when comparing to other national and international studies in general. However, it showed lower values when comparing the results to other national primary care studies. There was a higher number of haemorrhagic and cardiovascular events and suboptimal modifiable haemorrhagic risk factors in the group with bad therapeutic control, although those numbers were not statistically significant. This study shows there is still a long way to go when it comes to improving the treatment of AF in patients medicated with warfarin in primary care units. Hence, a broader approach of these patient is needed, in order to reduce their morbimortality. |
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ARE PATIENTS WITH ATRIAL FIBRILLATION MEDICATED WITH WARFARIN EFFECTIVELY HYPOCOAGULATED? OBSERVATIONAL STUDY IN TWO FAMILY HEALTH UNITS IN THE LISBON REGION.ESTARÃO OS DOENTES COM FIBRILHAÇÃO AURICULAR MEDICADOS COM VARFARINA EFICAZMENTE HIPOCOAGULADOS? ESTUDO OBSERVACIONAL EM DUAS UNIDADES DE SAÚDE FAMILIAR DA REGIÃO DE LISBOAfibrilhação auricularvarfarinaTTRatrial fibrillationwarfarinTTRAtrial fibrillation (AF) is one of the main causes of stroke and one way to reduce the associated risk is through effective anticoagulant therapy, which means maximizing the number of INRs in therapeutic range (TTR) when using warfarin in patients.This retrospective observational and analytical study aims to assess TTR indicators in patients receiving warfarin for atrial fibrillation under the medical care of two family health units in Lisbon, Portugal, as well as to compare the existence of suboptimal modifiable haemorrhagic risk factors and the number of haemorrhagic and cardiovascular events among patients with good or bad therapeutic control. In a total of 50 eligible patients, 57,8% had INR values within the therapeutic range and the average TTR value was 57,89%. When it comes to modifiable haemorrhagic risk factors, 22% of the patients had uncontrolled hypertension and 26% had been prescribed with nonsteroidal anti-inflammatory or anti-platelet drugs. In the group with bad therapeutic control, 58% of the patients had haemorrhagic and cardiovascular events (p = 0,288) and 58% had suboptimal modifiable haemorrhagic risk factors (p = 0,845). This study confirmed a good therapeutic control regarding warfarin use when comparing to other national and international studies in general. However, it showed lower values when comparing the results to other national primary care studies. There was a higher number of haemorrhagic and cardiovascular events and suboptimal modifiable haemorrhagic risk factors in the group with bad therapeutic control, although those numbers were not statistically significant. This study shows there is still a long way to go when it comes to improving the treatment of AF in patients medicated with warfarin in primary care units. Hence, a broader approach of these patient is needed, in order to reduce their morbimortality.A fibrilhação auricular (FA) é uma das principais causas de acidente vascular cerebral e a redução deste risco passa pela hipocoagulação eficaz, que se traduz por maximizar o número de INRs em intervalo terapêutico (TTR) nos doentes medicados com varfarina.Este estudo observacional e retrospetivo analítico teve como objetivos aferir os valores de TTR dos utentes medicados com varfarina por FA e inscritos em duas Unidades de Saúde Familiar e comparar a existência de fatores de risco potencialmente modificáveis e o número de eventos cardiovasculares e hemorrágicos entre os doentes com bom e mau controlo terapêutico. No total de 50 utentes elegíveis, 57,8% tinham valores de INR dentro do intervalo terapêutico e o valor médio de TTR foi 57,89%. Relativamente a fatores de risco modificáveis, 22% dos utentes apresentaram tensão arterial não controlada e 26% tinham prescritos anti-inflamatórios não esteroides ou anti-plaquetários. No grupo com mau controlo terapêutico, 58% tiveram eventos cardiovasculares e hemorrágicos (p = 0,288), e 58% apresentaram fatores de risco hemorrágico potencialmente modificáveis (p = 0,845). O presente estudo verificou um bom controlo terapêutico relativamente a estudos nacionais e internacionais e valores inferiores a estudos nos cuidados de saúde primários a nível nacional. Associado ao grupo com mau controlo terapêutico, existiu maior número de eventos cardiovasculares e hemorrágicos e fatores de risco potencialmente modificáveis, apesar da ausência de significado estatístico. Este estudo veio demonstrar que ainda existe um longo caminho a percorrer na melhoria do tratamento da FA em doentes hipocoagulados com varfarina nos cuidados de saúde primários, sendo necessária uma abordagem mais abrangente do utente de forma a diminuir a morbimortalidade nos mesmos.Revista Portuguesa de Hipertensão e Risco Cardiovascular2022-05-10info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.58043/rphrc.2https://doi.org/10.58043/rphrc.2Revista Portuguesa de Hipertensão e Risco Cardiovascular; N.º 87 (2022): Janeiro - Fevereiro; 20-261646-8287reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revistahipertensao.pt/index.php/rh/article/view/2https://revistahipertensao.pt/index.php/rh/article/view/2/4Direitos de Autor (c) 2022 Revista Portuguesa de Hipertensão e Risco Cardiovascularinfo:eu-repo/semantics/openAccessCorreia Tavares, InêsSantos Silva, InêsCró de Nóbrega, MónicaAntão, Cláudia2024-02-03T07:36:08Zoai:ojs.revistahipertensao.pt:article/2Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:05:06.788938Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
ARE PATIENTS WITH ATRIAL FIBRILLATION MEDICATED WITH WARFARIN EFFECTIVELY HYPOCOAGULATED? OBSERVATIONAL STUDY IN TWO FAMILY HEALTH UNITS IN THE LISBON REGION. ESTARÃO OS DOENTES COM FIBRILHAÇÃO AURICULAR MEDICADOS COM VARFARINA EFICAZMENTE HIPOCOAGULADOS? ESTUDO OBSERVACIONAL EM DUAS UNIDADES DE SAÚDE FAMILIAR DA REGIÃO DE LISBOA |
title |
ARE PATIENTS WITH ATRIAL FIBRILLATION MEDICATED WITH WARFARIN EFFECTIVELY HYPOCOAGULATED? OBSERVATIONAL STUDY IN TWO FAMILY HEALTH UNITS IN THE LISBON REGION. |
spellingShingle |
ARE PATIENTS WITH ATRIAL FIBRILLATION MEDICATED WITH WARFARIN EFFECTIVELY HYPOCOAGULATED? OBSERVATIONAL STUDY IN TWO FAMILY HEALTH UNITS IN THE LISBON REGION. Correia Tavares, Inês fibrilhação auricular varfarina TTR atrial fibrillation warfarin TTR |
title_short |
ARE PATIENTS WITH ATRIAL FIBRILLATION MEDICATED WITH WARFARIN EFFECTIVELY HYPOCOAGULATED? OBSERVATIONAL STUDY IN TWO FAMILY HEALTH UNITS IN THE LISBON REGION. |
title_full |
ARE PATIENTS WITH ATRIAL FIBRILLATION MEDICATED WITH WARFARIN EFFECTIVELY HYPOCOAGULATED? OBSERVATIONAL STUDY IN TWO FAMILY HEALTH UNITS IN THE LISBON REGION. |
title_fullStr |
ARE PATIENTS WITH ATRIAL FIBRILLATION MEDICATED WITH WARFARIN EFFECTIVELY HYPOCOAGULATED? OBSERVATIONAL STUDY IN TWO FAMILY HEALTH UNITS IN THE LISBON REGION. |
title_full_unstemmed |
ARE PATIENTS WITH ATRIAL FIBRILLATION MEDICATED WITH WARFARIN EFFECTIVELY HYPOCOAGULATED? OBSERVATIONAL STUDY IN TWO FAMILY HEALTH UNITS IN THE LISBON REGION. |
title_sort |
ARE PATIENTS WITH ATRIAL FIBRILLATION MEDICATED WITH WARFARIN EFFECTIVELY HYPOCOAGULATED? OBSERVATIONAL STUDY IN TWO FAMILY HEALTH UNITS IN THE LISBON REGION. |
author |
Correia Tavares, Inês |
author_facet |
Correia Tavares, Inês Santos Silva, Inês Cró de Nóbrega, Mónica Antão, Cláudia |
author_role |
author |
author2 |
Santos Silva, Inês Cró de Nóbrega, Mónica Antão, Cláudia |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Correia Tavares, Inês Santos Silva, Inês Cró de Nóbrega, Mónica Antão, Cláudia |
dc.subject.por.fl_str_mv |
fibrilhação auricular varfarina TTR atrial fibrillation warfarin TTR |
topic |
fibrilhação auricular varfarina TTR atrial fibrillation warfarin TTR |
description |
Atrial fibrillation (AF) is one of the main causes of stroke and one way to reduce the associated risk is through effective anticoagulant therapy, which means maximizing the number of INRs in therapeutic range (TTR) when using warfarin in patients.This retrospective observational and analytical study aims to assess TTR indicators in patients receiving warfarin for atrial fibrillation under the medical care of two family health units in Lisbon, Portugal, as well as to compare the existence of suboptimal modifiable haemorrhagic risk factors and the number of haemorrhagic and cardiovascular events among patients with good or bad therapeutic control. In a total of 50 eligible patients, 57,8% had INR values within the therapeutic range and the average TTR value was 57,89%. When it comes to modifiable haemorrhagic risk factors, 22% of the patients had uncontrolled hypertension and 26% had been prescribed with nonsteroidal anti-inflammatory or anti-platelet drugs. In the group with bad therapeutic control, 58% of the patients had haemorrhagic and cardiovascular events (p = 0,288) and 58% had suboptimal modifiable haemorrhagic risk factors (p = 0,845). This study confirmed a good therapeutic control regarding warfarin use when comparing to other national and international studies in general. However, it showed lower values when comparing the results to other national primary care studies. There was a higher number of haemorrhagic and cardiovascular events and suboptimal modifiable haemorrhagic risk factors in the group with bad therapeutic control, although those numbers were not statistically significant. This study shows there is still a long way to go when it comes to improving the treatment of AF in patients medicated with warfarin in primary care units. Hence, a broader approach of these patient is needed, in order to reduce their morbimortality. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-05-10 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.58043/rphrc.2 https://doi.org/10.58043/rphrc.2 |
url |
https://doi.org/10.58043/rphrc.2 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revistahipertensao.pt/index.php/rh/article/view/2 https://revistahipertensao.pt/index.php/rh/article/view/2/4 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2022 Revista Portuguesa de Hipertensão e Risco Cardiovascular info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Direitos de Autor (c) 2022 Revista Portuguesa de Hipertensão e Risco Cardiovascular |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Revista Portuguesa de Hipertensão e Risco Cardiovascular |
publisher.none.fl_str_mv |
Revista Portuguesa de Hipertensão e Risco Cardiovascular |
dc.source.none.fl_str_mv |
Revista Portuguesa de Hipertensão e Risco Cardiovascular; N.º 87 (2022): Janeiro - Fevereiro; 20-26 1646-8287 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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