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Anticoagulation Control with Acenocoumarol or Warfarin in Non-Valvular Atrial Fibrillation in Primary Care (Fantas-TIC Study)

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Equip d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Tarragona, Spain
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Campus Terres de l’Ebre, Universitat Rovira i Virgili, 43500 Tortosa, Tarragona, Spain
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Primary Care Intervention Evaluation Research Group (GAVINA Research Group), 43500 Tortosa, Tarragona, Spain
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Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 43500 Tortosa, Tarragona, Spain
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Unitat d’Avaluació, Direcció d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Tarragona, Spain
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Hospital Universitari de Bellvitge, Institut Català de la Salut, 08907 Barcelona, Spain
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Unitat Docent de Medicina de Familia i Comunitària, Tortosa-Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Tarragona, Spain
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Unitat de Recerca, Gerència Territorial Terres de l’Ebre (Institut Catalá de la Salut), 43500 Tortosa, Tarragona, Spain
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Authors to whom correspondence should be addressed.
Co-senior authors: M.R. Dalmau Llorca, C. Aguilar Martín, A.Q. Gonçalves and J. Fernández-Sáez. M.R. Dalmau Llorca is the Principal Investigator of this study.
Academic Editors: Giuseppe Biondi Zoccai and Marco Carmignani
Int. J. Environ. Res. Public Health 2021, 18(11), 5700; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115700
Received: 24 March 2021 / Revised: 6 May 2021 / Accepted: 18 May 2021 / Published: 26 May 2021
(This article belongs to the Section Health Care Sciences & Services)
Introduction: The use of vitamin K antagonists (VKAs) in non-valvular atrial fibrillation (NVAF) is complicated due to the narrow therapeutic margin they present and their unpredictable dose–response relationship. Most studies are based on warfarin, with the results being extrapolated to acenocoumarol. However, studies comparing the two treatments in terms of the degree of anticoagulation control are scarce, justifying the present study. Main factors associated with poor control of time in therapeutic range (TTR) of anticoagulated patients are also studied. Methods: Cross-sectional study, with real-world data from patients treated in primary care (PC). Data were obtained from the System for the Improvement of Research in PC (SIDIAP) database, covering 60,978 NVAF-anticoagulated patients from 287 PC centres in 2018. Descriptive statistics were derived, and odds ratios were estimated by multivariate logistic regression. Results: 41,430 patients were considered: 93% were being treated with acenocoumarol and 7% with warfarin. There was no difference in poor control of TTR between the two types of VKA treatment, acenocoumarol and warfarin (38.9 vs. 38.4; p = 0.610). Poor anticoagulation control was mainly associated with advanced alcoholism (OR = 1.38), liver failure (OR = 1.37) and intracranial haemorrhage (OR = 1.35) as well as female sex, age < 60 years, cardiovascular history, diabetes mellitus and other variables. Conclusions: There is no association between poor anticoagulation control and the type of VKA treatment administered. Factors associated with poor control of TTR must be considered in clinical practice to improve control and decision-making. View Full-Text
Keywords: atrial fibrillation; vitamin K antagonists; acenocoumarol; warfarin; time in therapeutic range atrial fibrillation; vitamin K antagonists; acenocoumarol; warfarin; time in therapeutic range
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MDPI and ACS Style

Dalmau Llorca, M.R.; Aguilar Martín, C.; Carrasco-Querol, N.; Hernández Rojas, Z.; Forcadell Drago, E.; Rodríguez Cumplido, D.; Castro Blanco, E.; Gonçalves, A.Q.; Fernández-Sáez, J. Anticoagulation Control with Acenocoumarol or Warfarin in Non-Valvular Atrial Fibrillation in Primary Care (Fantas-TIC Study). Int. J. Environ. Res. Public Health 2021, 18, 5700. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115700

AMA Style

Dalmau Llorca MR, Aguilar Martín C, Carrasco-Querol N, Hernández Rojas Z, Forcadell Drago E, Rodríguez Cumplido D, Castro Blanco E, Gonçalves AQ, Fernández-Sáez J. Anticoagulation Control with Acenocoumarol or Warfarin in Non-Valvular Atrial Fibrillation in Primary Care (Fantas-TIC Study). International Journal of Environmental Research and Public Health. 2021; 18(11):5700. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115700

Chicago/Turabian Style

Dalmau Llorca, M. R., Carina Aguilar Martín, Noèlia Carrasco-Querol, Zojaina Hernández Rojas, Emma Forcadell Drago, Dolores Rodríguez Cumplido, Elisabet Castro Blanco, Alessandra Q. Gonçalves, and José Fernández-Sáez. 2021. "Anticoagulation Control with Acenocoumarol or Warfarin in Non-Valvular Atrial Fibrillation in Primary Care (Fantas-TIC Study)" International Journal of Environmental Research and Public Health 18, no. 11: 5700. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115700

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