Skip to Main content Skip to Navigation
Master Thesis

Évaluation des pratiques de l’anticoagulation dans la fibrillation atriale non valvulaire. Les anticoagulants oraux directs ont-ils changé nos habitudes de prescription ? Étude à partir de deux cohortes dans le service de cardiologie au Centre Hospitalier de Périgueux

Abstract : Introduction: The Atrial Fibrillation (AF) is a common and serious pathology associated to a high risk of stroke. Despite their effectiveness, Vitamin K Antagonists (VKA) are underused with high-risk patients. We tried to understand anticoagulation practice at the Perigueux's hospital in the AF and assess the impact of the use of Novel Oral Anticoagulants (NOACs). Method: Two groups of patients in AF has been involved in 2012 and 2013 in the quantitative retrospective observational study, the first one cured by VKA only, the second by both VKA and NOAC. We studied characteristics and treatments according to CHA2DS2-VASC and those cured effectively. Results: Eligible cured and non-cured patients are statically comparable in the two groups for their age (p=0.3 in 2012, p=0.1 in 2013) and the CHA2DS2-VASC (p=0.57 in 2012, p=0.12 in 2013). The proportion of cured eligible patients is comparable between the two groups, around 77 % (p=0.95), despite the use of NOACs to 22.8% of eligible patients cured in 2013. Patients with NOAC are statically younger (p<0.001), lower bleeding risk (p=0.0019) and thrombo-embolism (p<0.001). The anemia, previous bleeding history, bleeding risk assessed by HAS-BLED, antiplatelet therapy and falling risk are the main reasons to not cure. Conclusion: There is a satisfactory proportion of eligible cured patients compared to the previous studies but the choice of non-curing is not always justified. After only one year, NOACs did not improve our practice.
Document type :
Master Thesis
Complete list of metadata

Cited literature [77 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-01157257
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, May 27, 2015 - 6:37:35 PM
Last modification on : Wednesday, August 23, 2017 - 4:29:30 PM

Identifiers

  • HAL Id : dumas-01157257, version 1

Collections

Citation

Julien Belval. Évaluation des pratiques de l’anticoagulation dans la fibrillation atriale non valvulaire. Les anticoagulants oraux directs ont-ils changé nos habitudes de prescription ? Étude à partir de deux cohortes dans le service de cardiologie au Centre Hospitalier de Périgueux. Médecine humaine et pathologie. 2015. ⟨dumas-01157257⟩

Share

Metrics

Record views

146

Files downloads

799