KẾT QUẢ ĐIỀU TRỊ THUỐC KHÁNG ĐÔNG KHÁNG VITAMIN K

Abstract

Introduction: The International Normalized Ratio (INR) and Time in Therapeutic Range (TTR) are two metrics used to evaluate the effectiveness of treatment and to adjust dosages appropriately based on clinical progress in patients indicated for the use of vitamin K antagonist anticoagulants. Objective: To investigate the treatment outcomes of vitamin K antagonist anticoagulants. Methods: A retrospective cross-sectional study was conducted. All patients prescribed vitamin K antagonist anticoagulants who revisited between January 2023 and June 2023 in Outpatient Department - University Medical Center HCMC and had at least four INR test results were included. Results: A total of 177 cases were surveyed, with an average age of 50.75 ± 15.90 years, and a male-to-female ratio of 0.83. The average follow-up duration was 39.85  months. Mechanical heart valves were present in 74.01% of cases, and isolated atrial fibrillation in 16.4%. The weekly dosage for warfarin was 10.77 ± 5.56 mg, and for acenocoumarol, 22.81 ± 8.49 mg. The average INR was 2.24 ± 0.91, with only 44.63% of cases achieving therapeutic targets, and the average TTR was 46.46 ± 29.28%. There were 25 cases of adverse events related to the medication. Conclusion: Vitamin K antagonist anticoagulants are effective in preventing thromboembolic events in mandatory indications. However, the rate of achieving therapeutic INR targets (44.63%) and time within the therapeutic range according to Rosendaal (46.46 ± 29.28%) are not high. Therefore, improving clinical monitoring, testing, and adherence to treatment is necessary to achieve better outcomes.