Publication details
Prevalence of thromboembolic complications in patients with atrial fibrillation in relation to a selected antithrombotic therapy
| Authors | |
|---|---|
| Year of publication | 2013 |
| Type | Article in Periodical |
| Magazine / Source | Biomedical Papers of the Faculty of Medicine of Palacký University |
| MU Faculty or unit | |
| Citation | |
| Web | http://biomed.papers.upol.cz/incpdfs/pri-990000-0500_10_031.pdf |
| Field | Surgery incl. transplantology |
| Keywords | atrial fibrillation; thromboembolism; anticoagulation; antiplatelet therapy |
| Description | Aim. The aim of this work was to find and characterize the correlation between the development of peripheral arterial thromboembolism and the selected medication for the atrial fibrillation-induced coagulopathy. Methods. The evaluated set included 103 patients admitted to the 2nd Department of Surgery, St. Anne’s University Hospital in Brno, during a period of 9 months. Patients were divided into individual groups on the basis of chronic medication of antithrombotic drugs, and the therapy effectiveness was evaluated on the basis of the thromboembolia prevalence. Results. In total, there were 36 thromboembolic complications; in 14 patients, it was a relapse. In the warfarin-administered group, thromboembolia occurred in 31.6 % patients and in the acetylsalicylic acid (ASA)-administered group, in 24.4 % of cases. The highest prevalence of peripheral arterial thromboembolism was observed in the group without any antithrombotic therapy, where this diagnosis was determined in 78.57 % of cases. A significant correlation (P=0.004; OR=7.94; CI 99% 1.183-53.33) was confirmed between the manifestation of coagulopathic states in patients with anticoagulation therapy and unmedicated patients. The smallest incidence of these complications was observed in the group with antiplatelet medication (P=0.0004; OR=11.33; CI 99% 1.693-75.89) compared to unmedicated patients. In the case of warfarin, the pharmacotherapy failure was caused by an insufficiently effective INR, which reached on average 1.42 +/- 0.53. Furthermore, a high impact of drug interactions cannot be definitely ruled out, especially in the case of antiplatelet ASA therapy, individually or in combination with clopidogrel. |