Clinical Impact of the Time in Therapeutic Range on Early Hospital Readmission in Patients with Acute Heart Failure Treated with Oral Anticoagulation in Internal Medicine

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dc.contributor.authorMartín Sánchez, Rubén Ángel
dc.contributor.authorLorenzo Villalba, Noel
dc.contributor.authorCalvo Elías, Alberto Elpidio
dc.contributor.authorDubón Peralta, Ester Emilia
dc.contributor.authorChocrón Benbunan, Cynthia Elisa
dc.contributor.authorCano de Luque, Carmen María
dc.contributor.authorLópez García, Lidia
dc.contributor.authorRivas Molinero, María
dc.contributor.authorOutón González, Cristina
dc.contributor.authorMarco Martínez, Javier
dc.contributor.authorCalvo Manuel, Elpidio
dc.contributor.authorAndrès, Emmanuel
dc.contributor.authorMéndez Bailón, Manuel
dc.date.accessioned2023-06-17T08:25:10Z
dc.date.available2023-06-17T08:25:10Z
dc.date.issued2021-04-09
dc.description.abstractBackground and objectives: Patients with heart failure (HF) often present with non-valvular atrial fibrillation and require oral anticoagulation with coumarin anticoagulants such as acenocoumarol. The objective of this study was to evaluate the relationship between time in therapeutic range (TTR) and the risk of early readmission. Materials and Methods: A retrospective descriptive study was carried out on hospitalized patients with a diagnosis of HF between 2014 and 2018 who had adverse effects due to oral anticoagulation with acenocoumarol (underdosing, overdosing, or hemorrhage). Clinical, analytical, therapeutic, and prognostic variables were collected. TTR is defined as the duration of time in which the patient’s International Normalized Ratio (INR) values were within a desired range. Early readmission was defined as readmission within 30 days after hospital discharge. Patients were divided into two groups depending on whether or not they had a TTR less than 60% (TTR < 60%) over the 6 months prior to the adverse event. Results: In the cohort of 304 patients, the mean age was 82 years, 59.9% of the patients were female, and 54.6% had a TTR < 60%. Patients with TTR < 60% had a higher HAS-BLED score (4.04 vs. 2.59; p < 0.001) and INR (6 vs. 5.31; p < 0.05) but lower hemoglobin (11.67 vs. 12.22 g/dL; p < 0.05). TTR < 60% was associated with early readmission after multivariate analysis (OR: 2.05 (CI 95%: 1.16–3.61)). They also had a higher percentage of hemorrhagic events and in-hospital mortality but without reaching statistical significance. Conclusions: Patients with HF and adverse events due to acenocoumarol often have poor INR control, which is independently associated with a higher risk of early readmission.
dc.description.departmentDepto. de Medicina
dc.description.facultyFac. de Medicina
dc.description.refereedTRUE
dc.description.statuspub
dc.eprint.idhttps://eprints.ucm.es/id/eprint/71659
dc.identifier.doi10.3390/medicina57040365
dc.identifier.issn1648-9144
dc.identifier.officialurlhttps://doi.org/10.3390/medicina57040365
dc.identifier.relatedurlhttps://www.mdpi.com/1648-9144/57/4/365/htm
dc.identifier.urihttps://hdl.handle.net/20.500.14352/7046
dc.issue.number4
dc.journal.titleMedicina
dc.language.isoeng
dc.page.initial365
dc.publisherMPDI
dc.rightsAtribución 3.0 España
dc.rights.accessRightsopen access
dc.rights.urihttps://creativecommons.org/licenses/by/3.0/es/
dc.subject.keywordheart failure
dc.subject.keywordnon-valvular atrial fibrillation
dc.subject.keywordacenocoumarol
dc.subject.keywordtime in therapeutic range
dc.subject.keywordreadmission
dc.subject.ucmCardiología
dc.subject.unesco3205.01 Cardiología
dc.titleClinical Impact of the Time in Therapeutic Range on Early Hospital Readmission in Patients with Acute Heart Failure Treated with Oral Anticoagulation in Internal Medicine
dc.typejournal article
dc.volume.number57
dspace.entity.typePublication
relation.isAuthorOfPublication42d41152-c320-491e-81de-2f601b12e9d8
relation.isAuthorOfPublication82609182-d105-446f-b580-243bb0b8f40b
relation.isAuthorOfPublication9635ebaf-1e70-4b67-9ba8-903104a39d00
relation.isAuthorOfPublication.latestForDiscovery42d41152-c320-491e-81de-2f601b12e9d8
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