Browsing by Subject "Anticoagulants"

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    Cessation of oral anticoagulation is an important risk factor for stroke and mortality in atrial fibrillation patients
    (2017) Rivera Caravaca, José Miguel; Roldán Schilling, Vanessa; Esteve Pastor, María Asunción; Valdés Chávarri, Mariano; Vicente García, Vicente; Lip, Gregory YH; Marín Ortuño, Francisco; Enfermería
    Oral anticoagulation (OAC) is highly effective preventing stroke and mortality in AF, but withdrawal is common in the elderly, when high bleeding risk and when are difficulties achieving an optimal time in therapeutic range (TTR). We analysed the rate of OAC cessation, predisposing factors to cessation and the relation to clinical outcomes in a large ‘real world’ cohort of AF patients over a long follow-up period. Consecutive non-valvular AF outpatients clinically stables for six months were recruited. Rates of cardiovascular events, major bleeding and mortality were recorded and related to OAC cessation. We included 1361 patients (48.7 % male; aged 76, IQR 71–81), followed-up for a median of 6.5 years. During follow-up, 244 patients suffered thrombotic events, 250 suffered from major bleeding and 551 patients died. 10 % of patients stopped OAC. After OAC withdrawal, there were 36 thromboembolic events (22 strokes), 10 major bleedings and 75 deaths. OAC cessation was independently associated with adverse cardiovascular events (HR 1.45; 95 % CI 1.01–2.08), stroke/TIA (HR 1.85; 1.17–2.94) and all-cause mortality (HR 1.30; 1.02–1.67). Independent predictors of OAC cessation were age 80 (HR 2.29; 1.60–3.29), previous coronary artery disease (HR 0.32; 0.15–0.71), major bleeding (HR 5.00; 3.49–7.15), heart failure (HR 2.38; 1.26-4.47), cancer (HR 5.24; 3.25–8.44) and renal impairment developed during follow-up (HR 2.70; 1.26–5.75). In conclusion, in non-valvular AF patients, cessation of OAC was independently associated with the risk of stroke, adverse cardiovascular events and mortality. Bleeding events and some variables associated with higher bleeding risk are responsible for OAC cessation.
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    Dental students’ knowledge of and attitudes toward anticoagulation dental treatment: assessment of a one-day course at the University of Murcia, Spain
    (Wiley, 2012-04-01) Martínez Beneyto, Yolanda; López Jornet, Pia; Camacho Alonso, Fabio; González Escribano, M.; Dermatología, Estomatología, Radiología y Medicina Física
    The aim of this study was to determine a group of Spanish dental students’ knowledge of and attitudes toward anticoagulated patients and clinical practice and to assess the need for additional education in this area. A survey with sections on demographics and knowledge of general coagulation, anticoagulation treatment, clinical practice, local hemostatic measures, and antibiotic prophylaxis was distributed to students before and after a one-day course on oral anticoagulation. The response rate was 67.1 percent (n=96). Of the respondents, 78.1 percent (seventy-five) were women. The students who benefited most from the course were third-year students since they had the lowest level of knowledge at the beginning of the course (p>0.05). Fifth-year students and postgraduates had a good initial level of knowledge (87 percent). This study identified a lack of knowledge among this group of Spanish dental students prior to the course, but participating in the course led to considerable improvement.
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    Manejo terapéutico de los usuarios con terapia anticoagulante oral
    (Murcia: Servicio de Publicaciones de la Universidad de Murcia, 2016) Barreiros Cascalho Serra, Isaura da Conceição; Ribeiro Afonso Nobre, Lurdes da Conceição; Gemito Grou Parreirinha, Maria Laurência; Mendes Parreira, Felismina Rosa
    Objetivo: Caracterizar a los usuarios con terapia anticoagulante oral; conocer el régimen de tratamiento y estimar los costes de evaluación de la International Normalized Ratio (INR). Metodologia: Estudio descriptivo, transversal, exploratorio, con 83 usuarios con terapia anticoagulante oral de un Centro de Salud de Alentejo. Los datos fueron recolectados con la aplicación de cuestionario construido para este fin. Resultados: Se concluyó que 50,6% informaron no saber qué es la coagulación; 49,4% lo que son anticoagulantes orales; 63,9% las complicaciones de la terapia anticoagulante oral. 27,7% conoce los alimentos que interfieren con esta terapia y 51,8% declara saber qué hacer en caso de lesión, cirugía o de la extracción de un diente. El costo de la evaluación de RNI (Razón Normalizada Internacional) en laboratorio es mayor que en los centros de salud. Conclusiones: Existen lagunas en el conocimiento sobre el proceso de coagulación, la interferencia de alimentación y el régimen. La descentralización de la consulta de enfermería puede reducir los costos, mejorar la accesibilidad y la gestión del régimen terapéutico.