Carlos H. Calderón-Franco, Departamento de Medicina Interna, Clínica de anticoagulación, Hospital Santa Clara, Bogotá, Colombia
Florina A. Rincón-Llaín, Departamento de Medicina Interna, Clínica de anticoagulación, Hospital Santa Clara, Bogotá, Colombia
Andrés F. Bastidas-Pinto, Departamento de Medicina Interna, Clínica de anticoagulación, Hospital Santa Clara, Bogotá, Colombia
Daniela A. Gómez-Mahecha, Departamento de Medicina Interna, Clínica de anticoagulación, Hospital Santa Clara, Bogotá, Colombia
Óscar A. Sáenz-Morales, Departamento de Medicina Interna, Clínica de anticoagulación, Hospital Santa Clara, Bogotá, Colombia
Miller D. Ruiz-Pinzón, Departamento de Medicina Interna, Clínica de anticoagulación, Hospital Santa Clara, Bogotá, Colombia
Juan P. Sáenz, Departamento de Medicina Interna, Clínica de anticoagulación, Hospital Santa Clara, Bogotá, Colombia
Osmar A. Pérez-Serrano, Departamento de Cardiología, Fundación Cínica Shaio, Grupo de Falla Cardíaca, Bogotá, Colombia
Introduction: Anticoagulation clinics have been implemented to optimize anticoagulant therapy and reduce hemorrhagic and thrombotic complications. Objective: To describe the sociodemographic and clinical characteristics of patients followed in an anticoagulation clinic in Bogotá, Colombia, and to identify factors associated with anticoagulation-related complications. Methods: It was conducted a retrospective observational analytical cohort study in ambulatory patients followed for up to three years. Sociodemographic, clinical variables and indications for anticoagulation were collected. Univariate and multivariate logistic regression models were used to estimate odds ratios (OR) with 95% confidence intervals (95% CI). Survival analysis was performed according to the type of anticoagulant (warfarin vs direct oral anticoagulants [DOAC]). Results: A total of 595 patients were included; 53.7% were women, with a mean age of 62 ± 14.1 years. Warfarin was prescribed in 40%, rivaroxaban in 19%, low-molecular-weight heparins in 12.9%, and apixaban in 11.7%. The main indications were atrial fibrillation (47.1%), hypercoagulable disorders (15.1%), intracardiac thrombus (15.9%), arterial thrombosis (9.9%), and venous thromboembolism (11.1%). Factors independently associated with complications were a history of thromboembolic events (OR: 11.3; 95% CI: 2.8-44.6) and a HAS-BLED score > 2 (OR: 6.9; 95% CI: 1.01-47.9). Event-free survival was lower with warfarin (0.87 per 1,000 person-years) compared with DOAC (0.97 per 1,000 person-years). Conclusions: Management within an anticoagulation clinic is associated with a favorable safety profile, with higher event-free survival among patients treated with DOAC. A prior history of thromboembolism and elevated HAS-BLED identify high-risk subgroups requiring closer follow-up.
Keywords: Anticoagulation clinic. Complications. Warfarin. Atrial fibrillation. Thromboembolic events. Direct oral anticoagulants.
