title: Ten-year experience with acenocoumarol treatment in an ambulatory cohort of Spanish patients.
abstract: OBJECTIVE
  To analyse incidence of hemorrhagic and thrombotic events in a series of ambulatory patients receiving acenocoumarol in a rural area of Spain (1997-2007).
  
  
  RESULTS
  Out of 1,544 patients, 1,086 are receiving acenocoumarol at present (2% of our region's population). The total follow-up was 5,462 patients-years. Median age was 74 years. INR therapeutic range was 2.0-3.0 in 82.5%. Atrial fibrillation (AF) was the most frequent indication (73%). Incidence of hemorrhagic and thrombotic events was 2.27 and 0.2/100 patients-year, respectively. Gastrointestinal tract was the most frequent site of bleeding. In multivariate analysis, patients with AF and prosthetic heart valves (PHV) had increased risk of bleeding (OR 2.1 and 4.8, respectively). Age and therapeutic ranges of INR were not associated with increased risk of bleeding.
  
  
  CONCLUSIONS
  2% of our population is receiving acenocoumarol. Incidence of hemorrhagic and thrombotic events was low. Patients with AF and PHV had increased risk of bleeding.
authors.affiliation: Internal Medicine Service, Hospital Sant Jaume, Mulleras, 15-17800, Olot, Girona, Spain. 34944jtv@comb.es
authors.forename: Joan-Carles
authors.initials: JC
authors.lastname: Trullas-Vila
authors.forename: Josep
authors.initials: J
authors.lastname: Bisbe-Company
authors.forename: Adriana
authors.initials: A
authors.lastname: Freitas-Ramírez
authors.forename: Silvia
authors.initials: S
authors.lastname: Soler-Simon
authors.forename: Vicenta
authors.initials: V
authors.lastname: Bisbe-Company
authors.forename: Josep-Maria
authors.initials: JM
authors.lastname: Roncero-Vidal
authors.forename: Rosa
authors.initials: R
authors.lastname: Gispert-Magarolas
mesh_terms: D000074:Acenocoumarol / Q000009:adverse effects / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000639:trends*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D019934:International Normalized Ratio / Q000639:trends; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000639:trends; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013927:Thrombosis / Q000139:chemically induced / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000074:Acenocoumarol