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Abstract
Oral dicumarinic anticoagulants are used in various pathologies for the primary and secondary prevention of venous and arterial thromboembolic events.
They have complex pharmacokinetics and pharmacodynamics resulting in a very narrow therapeutic range. Therefore, monitoring and strict control of anticoagulant therapy are essential. The efficacy of this medical treatment resides in a low percentage of ischemic and hemorrhagic episodes related to percentages of therapeutic interval time (TTR) associated with correctly controlled anticoagulation.
This retrospective study was carried out on 495 adults population who attended the Hemostasis and Thrombosis Department of the Transfusion Medicine Service of the Italian Hospital for being under treatment with oral anticoagulants, from which the TTR values were obtained from their medical records calculated by the Rosendaal method.
The purposes of this study are to determine the TTR to know the reached anticoagulation level and to assess whether age, gender, diagnosis and type of anticoagulant are associated with worse outcomes.
The median (Me) TRT value from the total samples was 64.0% (IIC 53.0 - 77.0). The mean out of range time (either above or below the accepted values) was also calculated with a value of 36.0% No statistically significant differences were found in the levels of TTR among the different groups or in the total of patients in the following variables: gender, type of anticoagulant and age. On the other hand, a statistically significant difference was found in the TTR value of the group of patients with valve replacement vs. patients with other diagnoses.
Knowing the TTR value is important, as it enables us to identify the level of anticoagulant care and to
establish new goals. Values obtained in this research are similar to the experience published by nationally
and internationally recognized anticoagulation sites and allow us to reconsider strategies to improve
quality and performance of service.
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