Ten-year experience with acenocoumarol treatment in an ambulatory cohort of Spanish patients.
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.
Trullas-Vila
Joan-Carles
JC
Internal Medicine Service, Hospital Sant Jaume, Mulleras, 15-17800, Olot, Girona, Spain. 34944jtv@comb.es
Bisbe-Company
Josep
J
Freitas-Ramírez
Adriana
A
Soler-Simon
Silvia
S
Bisbe-Company
Vicenta
V
Roncero-Vidal
Josep-Maria
JM
Gispert-Magarolas
Rosa
R
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
D000074:Acenocoumarol