Prevalence of adverse effects and efficacy of anticoagulant therapy with Dabigatran versus Warfarin in patients with non-valvular atrial fibrillation in the cardiology

Abstract

Introduction: Atrial fibrillation (AF) is the most frequent cardiac arrhythmia, affecting approximately 2% of the general population and its prevalence increases with age and the presence of risk factors; In addition, it can be associated with different comorbidities such as: AHT, DM, HF, AMI, among others. Objective: To determine the prevalence of adverse effects and efficacy of anticoagulant therapy with Dabigatran versus Warfarin in patients with non-valvular atrial fibrillation at the HTMC, from January 2014 to January 2018. Materials and methods: It is a retrospective study. , analytical and descriptive; the universe was made up of 500 HTMC patients with a diagnosis of atrial fibrillation. The data collection instrument was through the IESS AS400 system, in which the information was collected from the patients' medical records and stored in Microsoft Excel. A sample was obtained, according to the inclusion criteria, giving a total of 209 patients, divided into two groups, the first of 106 patients medicated with Warfarin and the second of 103 patients who were medicated with Dabigatran. Results: The results of the assessment of thromboembolic and hemorrhagic risk were obtained, based on the CHADS2VASC and HAS BLED scales, respectively. The patients presented the same comorbidities, there was no statistically significant difference between the different age and gender groups, neither for smoking and obesity; on the contrary, if there was a statistically significant difference for alcoholism, there is probably greater exposure to this cardiovascular risk factor in one of the groups; for heart failure, this would indicate a greater presence of heart failure in one of the groups. Conclusion: It was concluded that both groups had the same probability of presenting bleeding events through the HAS BLED score; however, the statistically significant P values for the different types of bleeding show that there is a higher prevalence of bleeding in one group than in another. It was determined that the patients medicated with Warfarin had a higher prevalence of bleeding during the 4 years of the study, unlike the group of patients medicated with Dabigatran.