Anticoagulation Management With Coumarinic Drugs in Chilean Patients

Clin Appl Thromb Hemost. 2019 Jan-Dec:25:1076029619834342. doi: 10.1177/1076029619834342.

Abstract

Warfarin and acenocoumarol are used in various cardiovascular disorders to improve the prognosis of patients with thromboembolic disease. However, there is a lack of substantial efficacy and safety data on antithrombotic prophylaxis in several countries, particularly in Latin America. The aim of this study was to provide information about the efficacy of anticoagulants in Chilean patients. Data were collected from databases of the Western Metropolitan Health Service, Santiago, Chile. We identified 6280 records of patients receiving anticoagulant treatment. The three most common diagnoses were rhythm disorder (43.7%), venous thrombosis (22%), and valvular prosthesis (10.7%). The majority of patients (98.5%) received acenocoumarol while 1.5% of patients received warfarin, at weekly therapeutic doses of 13.6 mg and 30.4 mg, respectively. For total diagnoses, the median time in the therapeutic range was 50%. However, better results, 66.7%, were observed when a telemedicine strategy was used only in Santiago Province. Our findings emphasize that in Chile, where the number of patients receiving anticoagulant treatment increases every year, telemedicine, by committed teams, improves the use of oral anticoagulants and is able to increase quality indicators of anticoagulant treatment care.

Keywords: acenocoumarol; safety; telemedicine; thrombosis; warfarin.

MeSH terms

  • Aged
  • Anticoagulants / pharmacology
  • Anticoagulants / therapeutic use*
  • Chile
  • Coumarins / pharmacology
  • Coumarins / therapeutic use*
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Telemedicine / methods*
  • Warfarin / pharmacology
  • Warfarin / therapeutic use*

Substances

  • Anticoagulants
  • Coumarins
  • Warfarin
  • coumarin