title: Low rate of bleeding and thrombotic complications of oral anticoagulant therapy independent of age in the real-practice of an anticoagulation clinic.
abstract: Over past years, there has been a world-wide increase in oral anticoagulant treatment (OAT). This study was aimed at evaluating the efficacy and safety of OAT managing in a real-practice situation. Nine hundred and three consecutive unselected patients referred for the control of OAT to the Anticoagulation Clinic of the University of Florence were studied. The total follow-up period was 1679 patient-years. The rate of total, major and fatal bleeding events was 5.0, 1.1 and 0.06 per 100 patient-years, respectively. In patients with a target International Normalized Ratio (INR) > or = 3, a significantly higher rate of bleeding (P = 0.02) with respect to patients with a target INR < 3 was observed. The rate of all thrombotic events was 3.8 per 100 patient-years. The rate of major and fatal thrombotic events were 2.4 and 0.4 per 100 patient-years, respectively. At INR >/= 4.5 the rate of bleeding was significantly higher (P = 0.005) than at lower INR. At INR < 2 the rate of all thrombotic events was significantly higher (P = 0.00001) with respect to more elevated intensities of anticoagulation. A low incidence of complications may be obtained even in elderly outpatients on OAT followed at an anticoagulation clinic.
authors.affiliation: Thrombosis Center, Department of Medical and Surgical Clinical Care, University of Florence, Azienda Ospedaliera Careggi, Viale Morgagni, 85-50134 Florence, Italy. polida@ao-careggi.toscana.it
authors.forename: Daniela
authors.initials: D
authors.lastname: Poli
authors.forename: Emilia
authors.initials: E
authors.lastname: Antonucci
authors.forename: Alessandra
authors.initials: A
authors.lastname: Lombardi
authors.forename: Vieri
authors.initials: V
authors.lastname: Boddi
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
authors.forename: Rosanna
authors.initials: R
authors.lastname: Abbate
authors.forename: Domenico
authors.initials: D
authors.lastname: Prisco
mesh_terms: D000074:Acenocoumarol / Q000008:administration & dosage / Q000494:pharmacology; D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000494:pharmacology*; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012984:Software; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*; D014859:Warfarin / Q000008:administration & dosage / Q000494:pharmacology
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D000074:Acenocoumarol