Factors related to the effect of vitamin K antagonist drugs
Keywords:
coagulation, anticoagulation, vitamin K antagonist drugsAbstract
Introduction: the prescription of vitamin K inhibitor drugs requires control of the anticoagulant effect.
Objective: to characterize patients with a history of treatment with warfarin sodium at the time of admission to the intensive care unit of the General Teaching Hospital “Dr. Agostinho Neto” during the 2016-2018 period.
Method: an analytical, retrospective and longitudinal study was carried out. 54 patients with the characteristics indicated were studied, which were grouped in a control group (n=16) with adequate anticoagulation and a study group (n=38) also with adequate anticoagulation. Sociodemographic, clinical and laboratory variables were studied.
Results: A total of 16 patients presented adequate level of anticoagulation and, in 38, level of anticoagulation was inadequate. Sodium warfarin was indicated more in patients with mechanical cardiac valve prostheses (20.0%), and inadequate anticoagulation was more common in these. The factors most related to adequate anticoagulation were frequent medical supervision (p=0.0000), who did not use drugs that interfere with the action of the drug (p=0.0000) and treatment compliance (p=0.0000). In 22 patients there were hemorrhagic complications and the most common was cerebral hemorrhage and, 16, they presented thromboembolic complications and the most frequent was cerebral embolism. Three patients died from bleeding complications and 9 from thromboembolic complications. In 21 patients the indication of the drug was inappropriate.
Conclusions: the need to control the adequate therapeutic adherence of the patient is revealed because the inadequate anticoagulant effect generates complications that can determine the death of the patient.
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