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Predictores de la elección de nuevos anticoagulantes directos en la fibrilación auricular y su adherencia al año;
Predictors for the Use of New Direct Anticoagulants in Atrial Fibrillation and Their One-Year Adherence

Creators:Castillo Costa, Yanina, Mauro, Víctor, Barsotti, Agostina, Hsu, Luisa, Charask, Adrián, Fairman, Enrique, Delfino, Flavio, Aquino, Nicolás, Rafaelli, Alessis, Barrero, Carlos

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Introducción: Los hombres con CHA2DS2-Vasc ≥ 1 o las mujeres con CHA2DS2-Vasc ≥ 2 y fibrilación/aleteo auricular tienenindicación de tratamiento antitrombótico al alta.Objetivos: Analizar la prevalencia del uso de anticoagulantes en esta población; hallar predictores del uso de nuevos anticoagulantesorales; y analizar la persistencia al año del tratamiento con nuevos anticoagulantes orales.Resultados: Pacientes consecutivos: 484. Los criterios de exclusión fueron la muerte intrahospitalaria (n: 12) y CHA2DS2-Vascde 0 en ambos géneros y de 1 en mujeres (67 pacientes). Los pacientes analizados fueron 405. Edad mediana: 76 años, génerofemenino: 46%, HTA: 76%, diabetes: 25%, accidente cerebrovascular previo: 10%, antecedentes de fibrilación/aleteo auricular:30%. Estrategia de control de ritmo: 66%. Fueron anticoagulados al alta 293 pacientes (72%). Entre los pacientes anticoagulados,los nuevos anticoagulantes orales fueron los más utilizados: 63,5%, especialmente en los menos añosos (74 versus 79,5años, p: 0,001), con menos antecedentes de accidente cerebrovascular (5,8% versus 18%, p &lt; 0,001), menor CHA2DS2-Vascmediana (3 versus 4, p &lt; 0,01) y HAS-BLED mediana (1 versus 2, p &lt; 0,01) y en más pacientes con ritmo sinusal al momentodel alta (73,8% versus 54,7%, p &lt; 0,001). De los 165 pacientes externados con nuevos anticoagulantes orales y seguidos alaño, el 55,7% mantuvieron el nuevo anticoagulante oral indicado, un 29,69% habían discontinuado la anticoagulación y el14,5% rotó a acenocumarol.Conclusiones: En nuestro trabajo, se anticoagula al alta solo al 70% de los pacientes. Se utilizaron nuevos anticoagulantesorales en más de la mitad de los casos, especialmente en los pacientes de menor riesgo clínico. Al año de seguimiento, cada10 pacientes medicados al alta con nuevos anticoagulantes orales, 6 persisten con ese tratamiento, 1 rota a acenocumarol y3 dejan de estar anticoagulados.

Background: Men with CHA2DS2-Vasc score ≥1 or women with CHA2DS2-Vasc score ≥2 and atrial fibrillation/flutter have highindication of antithrombotic treatment.Objective: The aim of this study was to analyze the prevalence of anticoagulant therapy in this population, to find predictorsfor the use of new oral anticoagulants and to analyze the one-year adherence to treatment.Methods: A total of 484 consecutive patients were included in the study. Exclusion criteria were in-hospital mortality (n=12) andCHA2DS2-Vasc score of 0 in both genders and 1 in women (n=67). Finally, 405 patients were analyzed with median age of 76years, 46% women, 76% hypertensive, 25% diabetic, 10% with previous stroke and 30% with history of atrial fibrillation/flutter.Results: A rhythm control strategy was used in 66% of cases and 293 patients were anticoagulated at discharge (72%). Amonganticoagulated patients, 63.5% received new oral anticoagulants, especially those who were younger (74 vs. 79.5 years, p=0.001),with lower history of stroke (5.8% vs.18%, p&lt;0.001), lower median CHA2DS2-Vasc (3 vs.4, p&lt;0.01) and HAS-BLED (1 vs. 2,p&lt;0.01) scores and with sinus rhythm at discharge (73.8% vs. 54.7%, p&lt;0.001). Among 165 patients discharged with new oralanticoagulants and followed up for one year, 55.7% adhered to the indicated new oral anticoagulant, 29.69% had discontinuedthe anticoagulation treatment and 14.5% had switched to acenocoumarol.Conclusions: The study shows that only 70 of patients are anticoagulated at discharge. New oral anticoagulants were usedin more than half of cases, especially in patients at lower clinical risk. At one-year follow-up, 6 out of every 10 patients withindication of new oral anticoagulants at discharge continue this treatment, 1 switches to acenocoumarol and 3 abandonanticoagulant therapy.

Metadatos destacados

Colecciones
Argentine Journal of Cardiology

Editor

Sociedad Argentina de Cardiología

Fuente

Revista Argentina de Cardiología; Vol 87, No 5 (2019); 365-370, Argentine Journal of Cardiology; Vol 87, No 5 (2019); 365-370

Citación

Castillo Costa, Yanina et al., “Predictores de la elección de nuevos anticoagulantes directos en la fibrilación auricular y su adherencia al año,” Archivo PPCT, consulta 2 de abril de 2026, http://archivoppct.caicyt.gov.ar/items/show/9589.

Dublin Core

Autor

Castillo Costa, Yanina
Mauro, Víctor
Barsotti, Agostina
Hsu, Luisa
Charask, Adrián
Fairman, Enrique
Delfino, Flavio
Aquino, Nicolás
Rafaelli, Alessis
Barrero, Carlos

Fuente

Revista Argentina de Cardiología; Vol 87, No 5 (2019); 365-370
Argentine Journal of Cardiology; Vol 87, No 5 (2019); 365-370

Editor

Sociedad Argentina de Cardiología

Fecha

2019-11-15

Derechos

Los que firman al pié, certificamos que tenemos total responsabilidad por la conducción de este estudio y por el diseño y la interpretación de los datos. Nosotros escribimos el manuscrito y somos responsables por la decisión acerca del mismo. Cada uno de nosotros cumple la definición de autor como se afirma en el Comité Internacional de Editores de Revistas Médicas (International Committee of Medical Journal Editors, ver www.icmje.org). Nosotros hemos visto y aprobado el manuscrito final. Ni el artículo, ni ninguna parte esencial del mismo, incluido las tablas y las figuras, será publicado o admitido para arbitrar a otra parte antes de aparecer en la Revista.También notificamos haber leído la sección “conflicto de intereses”, y revelaríamos cualquiera que existiera. Dejamos constancia que si nuestro artículo se publicara en la RAC, cederíamos los derechos (copyright) a la Revista.Los documentos publicados en esta revista están bajo la licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.
Those signing below certify that we have full responsibility for the conduction of this study and for the design and interpretation of the information. We wrote the manuscript and are responsible for its decision. Each of us fulfills the definition of authorship as stated by the International Committee of Medical Journal Editors ( www.icmje.org). We have signed and approved the final manuscript. Neither the manuscript, nor any essential part thereof, including tables and figures, will be published or accepted for refereeing elsewhere before being published in the Journal. We have also read the "Conflict of Interest" section and would disclose any existing. We state that if our manuscript is published in the RAC, we shall transfer the copyright to the Journal.

Idioma

eng
spa

Tipo

info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion