Manuel Anguita Sánchez1, Vicente Bertomeu Martínez2, Ángel Cequier Fillat3. 1. Agencia de Investigación, Sociedad Española de Cardiología, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain. Electronic address: manuelp.anguita.sspa@juntadeandalucia.es. 2. Agencia de Investigación, Sociedad Española de Cardiología, Madrid, Spain; Servicio de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain. 3. Agencia de Investigación, Sociedad Española de Cardiología, Madrid, Spain; Servicio de Cardiología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
Abstract
INTRODUCTION AND OBJECTIVES: To study the prevalence of poorly controlled vitamin K antagonist anticoagulation in Spain in patients with nonvalvular atrial fibrillation, and to identify associated factors. METHODS: We studied 1056 consecutive patients seen at 120 cardiology clinics in Spain between November 2013 and March 2014. We analyzed the international normalized ratio from the 6 months prior to the patient's visit, calculating the prevalence of poorly controlled anticoagulation, defined as < 65% time in therapeutic range using the Rosendaal method. RESULTS: Mean age was 73.6 years (standard deviation, 9.8 years); women accounted for 42% of patients. The prevalence of poorly controlled anticoagulation was 47.3%. Mean time in therapeutic range was 63.8% (25.9%). The following factors were independently associated with poorly controlled anticoagulation: kidney disease (odds ratio = 1.53; 95% confidence interval, 1.08-2.18; P = .018), routine nonsteroidal anti-inflammatory drugs (odds ratio = 1.79; 95% confidence interval, 1.20-2.79; P = .004), antiplatelet therapy (odds ratio = 2.16; 95% confidence interval, 1.49-3.12; P < .0001) and absence of angiotensin receptor blockers (odds ratio = 1.39; 95% confidence interval, 1.08-1.79; P = .011). CONCLUSIONS: There is a high prevalence of poorly controlled vitamin K antagonist anticoagulation in Spain. Factors associated with poor control are kidney disease, routine nonsteroidal anti-inflammatory drugs, antiplatelet use, and absence of angiotensin receptor blockers.
INTRODUCTION AND OBJECTIVES: To study the prevalence of poorly controlled vitamin K antagonist anticoagulation in Spain in patients with nonvalvular atrial fibrillation, and to identify associated factors. METHODS: We studied 1056 consecutive patients seen at 120 cardiology clinics in Spain between November 2013 and March 2014. We analyzed the international normalized ratio from the 6 months prior to the patient's visit, calculating the prevalence of poorly controlled anticoagulation, defined as < 65% time in therapeutic range using the Rosendaal method. RESULTS: Mean age was 73.6 years (standard deviation, 9.8 years); women accounted for 42% of patients. The prevalence of poorly controlled anticoagulation was 47.3%. Mean time in therapeutic range was 63.8% (25.9%). The following factors were independently associated with poorly controlled anticoagulation: kidney disease (odds ratio = 1.53; 95% confidence interval, 1.08-2.18; P = .018), routine nonsteroidal anti-inflammatory drugs (odds ratio = 1.79; 95% confidence interval, 1.20-2.79; P = .004), antiplatelet therapy (odds ratio = 2.16; 95% confidence interval, 1.49-3.12; P < .0001) and absence of angiotensin receptor blockers (odds ratio = 1.39; 95% confidence interval, 1.08-1.79; P = .011). CONCLUSIONS: There is a high prevalence of poorly controlled vitamin K antagonist anticoagulation in Spain. Factors associated with poor control are kidney disease, routine nonsteroidal anti-inflammatory drugs, antiplatelet use, and absence of angiotensin receptor blockers.
Keywords:
Antagonistas de la vitamina K; Anticoagulantes orales; Fibrilación auricular no valvular; Método de Rosendaal; Nonvalvular atrial fibrillation; Oral anticoagulants; Rosendaal method; Vitamin K antagonists
Authors: P Carrasco-Garrido; V Hernández-Barrera; J Esteban-Hernández; I Jiménez-Trujillo; A Álvaro-Meca; A López de Andrés; J de Miguel Diez; J M Rodríguez Barrios; J A Muñoz Robles; R Jiménez-García Journal: BMJ Open Date: 2017-01-10 Impact factor: 2.692
Authors: Carmen Suárez Fernández; Luis Castilla-Guerra; Jesus Cantero Hinojosa; Josep Maria Suriñach; Fernando Acosta de Bilbao; Juan José Tamarit; José Luis Diaz Diaz; Jose Luis Hernandez; Antonio Pose; Manuel Montero-Pérez-Barquero; Jaume Roquer; Jaime Gállego; José Vivancos; Jose María Mostaza Journal: Patient Prefer Adherence Date: 2018-02-19 Impact factor: 2.711
Authors: Aníbal García-Sempere; Isabel Hurtado; Daniel Bejarano-Quisoboni; Clara Rodríguez-Bernal; Yared Santa-Ana; Salvador Peiró; Gabriel Sanfélix-Gimeno Journal: PLoS One Date: 2019-02-12 Impact factor: 3.240
Authors: Carlos Escobar; Xavier Borrás; Ramón Bover Freire; Carlos González-Juanatey; Miren Morillas; Alfonso Valle Muñoz; Juan José Gómez-Doblas Journal: PLoS One Date: 2020-06-01 Impact factor: 3.240
Authors: Leovigildo Ginel-Mendoza; Alfonso Hidalgo-Natera; Rocío Reina-Gonzalez; Rafael Poyato-Ramos; Juana Morales-Naranjo; Inmaculada Lupiañez-Pérez; Antonio Baca-Osorio; Miguel Gutiérrez-Jansen; María Paz Fernández-Lara; Diego Lozano-Noriega; Ulises Salgado-Carvallo; Cristina Bandera-García; Francisco Javier Navarro-Moya Journal: Trials Date: 2021-01-11 Impact factor: 2.279
Authors: M Rosa Dalmau Llorca; Carina Aguilar Martín; Noèlia Carrasco-Querol; Zojaina Hernández Rojas; Emma Forcadell Drago; Dolores Rodríguez Cumplido; Elisabet Castro Blanco; Alessandra Queiroga Gonçalves; José Fernández-Sáez Journal: Int J Environ Res Public Health Date: 2021-05-26 Impact factor: 3.390