[Temps passé dans l'intervalle thérapeutique dans la maladie veineuse thrombo-embolique : intérêt dans la prévention des complications].

BACKGROUND

Vitamin K antagonists (VKAs) are the most commonly prescribed drug for the treatment of venous thromboembolism (VTE). Our study's aim was to evaluate the role of Time in Therapeutic Range (TTR) in preventing thrombotic and hemorrhagic complications in patients treated by VKAs for VTE.

METHODS

Our study is prospective, descriptive, and longitudinal, including patients admitted to an Internal Medicine department in Tunis, during a 9-month period. One hundred patients diagnosed with VTE confirmed with imaging and treated with VKAs were included. TTR was calculated using Rosendaal's method through a free software INR PRO©.

RESULTS

The mean age of patients was 59.4 ± 16.7 years. Sex-ratio was 1.5. VKAs were mainly prescribed for deep venous thromboses (57%). Cancer was the most common etiology (26%). The mean follow-up period was 5.3 months. The mean TTR was 36.1±22.5%. Twenty-seven percent of patients had a TTR>50%. We noted 25% of hemorrhagic events and 15% of thromboembolic recurrence. A TTR<50% was correlated with hemorrhagic complications (p=0.02), but not with thrombotic ones (p = 0.224).

CONCLUSION

Our results outline the necessity of implementing adequate tools to improve anticoagulation in our population. Implementing TTR as a quality assessment tool for anticoagulation will likely decrease complications related to VKAs.