ASSESSMENT OF TIME IN THERAPEUTIC RANGE IN PATIENTS ANTICOAGULATED WITH DICOUMARINS ATTENDING THE HEMATOLOGY DEPARTMENT OF THE NATIONAL MEDICAL CENTER – NATIONAL HOSPITAL, FROM 2022 TO 2024

Abstract

INTRODUCTION: The use of dicoumarins (acenocoumarol and warfarin) is one of the most widely used anticoagulant therapies worldwide. Its effectiveness depends on maintaining an INR between 2 and 3. Multiple factors may interfere with this monitoring. Inadequate control of time in therapeutic range predisposes patients to cerebrovascular accidents or other thromboembolic events despite anticoagulant use. The occurrence of these complications negatively affects morbidity and mortality in these patients. OBJECTIVE: To determine the time in therapeutic range and associated factors in patients receiving dicoumarin anticoagulation at the National Hospital. METHODOLOGY: An observational, descriptive, cross-sectional study was conducted in patients receiving dicoumarin anticoagulation who underwent monitoring at the Hematology Department outpatient clinic. RESULTS: Of the total patients receiving anticoagulant treatment, 53% were male and 56% were over 60 years of age. The main indication for anticoagulation was atrial fibrillation (45%). Approximately 85% of patients had a time in therapeutic range below 65% during treatment. CONCLUSION: Most patients receiving anticoagulant treatment were men. The predominant age group was 61 to 70 years. Atrial fibrillation was the main indication for anticoagulation. Approximately 85% of patients failed to achieve an adequate time in therapeutic range during treatment. Hemorrhagic complications were uncommon. No significant association was observed between the anticoagulant used, whether acenocoumarol or warfarin, and achieving time in therapeutic range, nor was there a significant association with sex.