Ten-year experience with acenocoumarol treatment in an ambulatory cohort of Spanish patients

Objective To analyse incidence of hemorrhagic and thrombotic events in a series of ambulatory patients receiving acenocoumarol in a rural area of Spain (1997-2007). Results Out of 1,544 patients, 1,086 are receiving acenocoumarol at present (2% of our region's population). The total follow-up was 5,462 patients-years. Median age was 74 years. INR therapeutic range was 2.0-3.0 in 82.5%. Atrial fibrillation (AF) was the most frequent indication (73%). Incidence of hemorrhagic and thrombotic events was 2.27 and 0.2/100 patients-year, respectively. Gastrointestinal tract was the most frequent site of bleeding. In multivariate analysis, patients with AF and prosthetic heart valves (PHV) had increased risk of bleeding ( OR 2.1 and 4.8, respectively). Age and therapeutic ranges of INR were not associated with increased risk of bleeding. Conclusions 2% of our population is receiving acenocoumarol. Incidence of hemorrhagic and thrombotic events was low. Patients with AF and PHV had increased risk of bleeding.