
Resumo: Introdução e objetivos: Na fibrilhação auricular o controlo da hipocoagulação avaliado pelo tempo em alvo terapêutico correlaciona‐se positivamente com a segurança e eficácia tromboprofiláticas. Pretende‐se realizar essa avaliação na unidade dos autores e pesquisar determinantes de melhor controlo. Métodos: Série de casos – utentes da Unidade de Saúde Familiar de Fânzeres com fibrilhação auricular sob varfarina ou acenocumarol. Colheram‐se dados sociodemográficos e clínicos; calculou‐se o tempo em alvo terapêutico pelo método de Rosendaal, usando os resultados de Razão Normalizada Internacional realizados em laboratórios externos à unidade nos seis meses precedentes. Os dados foram tratados em SPSS 21.0®, recorrendo‐se a estatística descritiva, correlação de Spearman, teste de Mann‐Whitney U e Kruskal‐Wallis. Resultados: Participaram 70% dos 106 pacientes elegíveis. O tempo em alvo terapêutico mediano foi de 65,3% (P25 = 48,3%; P75 = 86,8%). Encontrou‐se relação positiva entre essa variável e duração da doença (ρ = 0,477; p 0,05). Conclusões: O tempo em alvo terapêutico mediano na unidade é semelhante ao dos países sul europeus, ficando próximo do «bom controlo» definido pela Sociedade Europeia de Cardiologia (70%). A duração da fibrilhação auricular e da hipocoagulação explicam uma pequena parte da variabilidade dessa medida. Serão necessários estudos para identificação de outros determinantes do controlo da hipocoagulação e estudos comparativos com unidades que realizem os testes laboratoriais de monitorização da hipocoagulação nas suas instalações. Abstract: Introduction and Aims: Anticoagulation control as assessed by time in therapeutic range (TTR) correlates positively with the safety and efficacy of thromboprophylaxis in atrial fibrillation. We set out to assess TTR in our unit and to investigate determinants of better control. Methods: This was a case series study of atrial fibrillation patients anticoagulated with warfarin or acenocoumarol at the Family Health Unit of Fânzeres. Sociodemographic and clinical data were collected and TTR was calculated by the Rosendaal method, based on international normalized ratio tests performed in external laboratories in the preceding six months. SPSS® 21.0 was used for the statistical analysis, with descriptive statistics, Spearman's correlation, and the Mann‐Whitney U and Kruskal‐Wallis tests. Results: Of the 106 eligible patients, 70% participated in the study. Median TTR was 65.3% (P25 = 48.3%, P75 = 86.8%). We found a positive association between this variable and duration of atrial fibrillation (ρ =0.477, p 0.05). Conclusions: Median TTR in our unit is similar to that in southern European countries and close to the good control threshold (70%) proposed by the European Society of Cardiology. The duration of atrial fibrillation and of anticoagulation explains only a small part of the measure's variability. Other determinants of anticoagulation control must be investigated in future studies and comparative studies should be carried out in family health units monitoring anticoagulation on the premises. Palavras‐chave: Fibrilhação auricular, Anticoagulantes, Tempo em alvo terapêutico, Keywords: Atrial fibrillation, Anticoagulants, Time in therapeutic range
RC666-701, Diseases of the circulatory (Cardiovascular) system
RC666-701, Diseases of the circulatory (Cardiovascular) system
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