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Revista Medica Herediana
versión impresa ISSN 1018-130X
Resumen
GAMERO, María T; CORNEJO, Marilhia; DUENAS, Roy y SAMALVIDES, Frine. Factors associated with optimal oral anticoagulation in elder patients with atrial fibrillation. Rev Med Hered [online]. 2017, vol.28, n.2, pp.84-92. ISSN 1018-130X. http://dx.doi.org/https://doi.org/10.20453/rmh.v28i2.3108.
Objective: To determine the quality of oral anticoagulation control and the possible factors associated with time to reach therapeutic range. Methods: Retrospective study with a control group in patients =65 years old with nonvalvular atrial fibrillation who had indication for oral anticoagulation at Hospital Cayetano Heredia from 2011 to 2013. Time to therapeutic range (TTR) was determined by the Rosendal´s method, an optimal control was defined as TTR =60%. A multivariate analysis was performed. Results: Median age was 82.23 years; 74 (51.75%) were females; 140 patients had indication for anticoagulation; 94 (67.14%) started warfarin; 28 (19.72%) had optimal control and 66 did not (46.48%). Age = 75 years (OR 25.5; CI: 7.39-155.8) and no low degree of instruction (OR 25.5; CI: 7.39-155.8) were associated with sub optimal control, while functional independence (OR 4.3; CI: 2.16-9.47), no cognitive deterioration (OR 7.8; CI: 3.53-20.19) and female gender (OR 3; CI: 1.62-5.81) were associated with optimal control. Conclusions: A great percentage of patients with indications for oral anticoagulation and at low risk of bleeding did not start it, and 50% of those who started it had suboptimal control. Older patients with comorbidities who used multiple medications had sub optimal control, while females and functional independence were associated with optimal control.
Palabras clave : Atrial fibrillation; warfarin; aged; stroke.