Quality of anticoagulation among patients with nonvalvular atrial fibrillation in the Primary health care center 'Novi Beograd'

Introduction: The risk of stroke in atrial fibrillation (AF) can be significantly reduced by appropriate thromboembolic prophylaxis. Vitamin K antagonists (VKA) are the first and only therapeutic choice for majority of our patients; however, in daily practice it is difficult to achieve target coagulation status and patients are often exposed to an unnecessary risk of thromboembolic or bleeding complications. Objective: The purpose of this study was to estimate the quality of anticoagulation in patients with atrial fibrillation in community practice, expressed as the time in the therapeutic range (TTR) and its relationship to clinical outcomes: stroke, systemic embolism and hemorrhage. Method: This retrospective study included 198 patients with non-valvular atrial fibrillation, who were managed in the Primary health center 'Novi Beograd' from September the 2014 to January the 2016. Results: Average time in therapeutic range was 61.21% ±25.4%. Poorly managed INR defined as TTR <65% was registered in 43.5% of patients. During the follow-up period there were no new thromboemolic events, but in 7.5% of studied population a bleeding occurred. Complications were more common in patients with poor INR control, but the difference was not statistically significant (χ²=1.195, p=0.274 DF1). Conclusion: The quality of INR control assessed by average time TTR of 61.21%, although below the recommended values (TTR>65%), can be regarded as good since it did not significantly differed from other European countries.