Problems encountered in long-term treatment with anticoagulants

Area of Science:

• Pharmacology
• Clinical Medicine
• Patient Outcomes

Background:

• Long-term anticoagulant therapy is crucial for managing various cardiovascular conditions.
• Monitoring therapeutic efficacy and safety is essential for patient well-being.
• Understanding risk factors and drug interactions is key to optimizing anticoagulant treatment.

Purpose of the Study:

• To evaluate the outcomes of long-term anticoagulant therapy in outpatients.
• To assess the relationship between prothrombin complex activity (PP%) levels and adverse events (bleeding, thromboembolism).
• To compare the safety and efficacy of different anticoagulant drugs and identify risk factors.

Main Methods:

• Retrospective evaluation of 114 outpatients undergoing long-term anticoagulant therapy over three months.
• Data collection through clinical records and two personal interviews per patient.
• Analysis of prothrombin complex activity (PP%) levels in relation to bleeding and thromboembolic events.

Main Results:

• Prothrombin complex activity (PP%) levels were significantly lower in patients experiencing bleeding episodes.
• No bleeding occurred when PP% was maintained above 25%.
• Warfarin demonstrated fewer bleeding episodes and a higher proportion of PP% values within the target range (10-25%) compared to phenprocoumon and bishydroxycoumarin.

Conclusions:

• Warfarin appears to be a safer and more effective anticoagulant option compared to phenprocoumon and bishydroxycoumarin in this patient cohort.
• Age was confirmed as a risk factor for adverse events, while moderate hypertension was not.
• A significant percentage of patients (37.5%) experienced probable adverse drug interactions, highlighting the need for careful medication review.