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[Clinical and laboratory evaluation of patients treated with oral anticoagulation]
D M Lourenço1, L H Lopes, C V Vignal
1Hematologia e Hemoterapia da Universidade Federal de São Paulo.
Purpose:
To evaluate the clinical and laboratory management of patients taking anti-vitamin K drugs (AVK).
Methods:
We studied retrospectively 952 visits of 100 outpatients taking AVK drugs for 7.6 months. There were 56 men and 44 women, 54 patients had acute arterial occlusion, 34 presented venous thromboembolism and 12 had cardiopathy. Anticoagulation level was estimated by the prothrombin time reported as international normalized ratio (INR).
Results:
Seventy-three patients were considered stable, as they had one visit every at least 3 weeks, and their INR was within the therapeutic range in 59% of their visits, whereas 27 patients were less stable and had 36% of their visits within the therapeutic range. Insufficient anticoagulation was due to poor compliance (22%), vitamin K rich diet (19%) and underdosage (16%). Four patients presented minor bleedings, and there was no recurrence of thromboembolism.
Conclusion:
Careful clinical and laboratory management, using the INR, are necessary to avoid hemorrhage and thrombotic complications in patients taking oral anticoagulants.