EC Cardiology

No one can deny the great contribution that Acenocoumarol has made as an anticoagulant, mainly through its use in non-valvular atrial fibrillation.

However, there are currently other types of anticoagulants that do not require such exhaustive INR control and therefore have fewer side effects than Acenocoumarol.

Spain is one of the few countries in Europe that still prescribes Acenocoumarol, similar to warfarin. So much so that primary care physicians are not allowed to prescribe other anticoagulants that are more effective and less bothersome for the patient when taking the digital INR test. The study was performed in a primary care health system and secondary category hospitals. We were setting in a population of 2650 inhabitants in southeastern Spain (Number of patients to be treated is sufficient) with non-valvular atrial fibrillation and acenocoumarol takers. The follow-up time was 12 months.

The statistical study was limited to an “observational/descriptive” study, taking into account the variations and lability of the INR value (International Normalized Ratio), whose figures universally considered-regardless of the type of cardiovascular pathology-have been proposed to be between 2 - 3, in a maximum term of one determination every 28 days, regardless of the figures obtained concerning previous ones.

Given that the vast majority of Acenocoumarol intake occurs in elderly patients-over 65 years of age-and that these individuals are usually subject to a polymedication regimen, the medications taken by each of them were a fundamental reason for the assessment.

As fundamental conclusions in this clinical study, we must say that: In time between INR determination and last intake of food and medication are not being correct; they tend to be anarchic INR determinations and when it is most convenient; research regarding drugs taken concomitantly with Acenocoumarol practically does not exist.

Keywords: Anticoagulants; Acenocoumarol; Misuse of Anticoagulants; Non-Valvular Atrial Fibrillation

1. FR Breijo-Marquez. “Misuse of the Drug Acenocoumarol in a Population of 250 Inhabitants with Non-valvular Atrial Fibrillation Assessed in a Region of Southeaster of Spain". Acta Scientific Medical Sciences 12 (2022): 44-48.
2. Romain Siriez., et al. “Comparison of analytical performances between clot waveform analysis and FibWave in edoxaban-treated patients and healthy controls”. Research and Practice in Thrombosis and Haemostasis7 (2022): e12804.
3. Kearon C., et al. “Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report”. Chest2 (2016): 315‐352.
4. Steffel J., et al. “2021 European Heart Rhythm Association practical guide on the use of non‐vitamin K antagonist Oral anticoagulants in patients with atrial fibrillation”. Europace10 (2021): 1612‐1676.
5. Gosselin RC., et al. “Clinical pearls: laboratory assessments of direct oral anticoagulants (DOACS)”. Hamostaseologie4 (2017): 295‐301.
6. Douxfils J., et al. “Laboratory testing in patients treated with direct oral anticoagulants: a practical guide for clinicians”. Journal of Thrombosis and Haemostasis 2 (2018): 209‐219.
7. Carina Aguilar Martín., et al. “Oral Anticoagulant Adequacy in Non-Valvular Atrial Fibrillation in Primary Care: A Cross-Sectional Study Using Real-World Data (Fantas-TIC Study)”. International Journal of Environmental Research and Public Health 5 (2021): 2244.
8. Sutfin T., et al. “Stereoselective interaction of omeprazole with warfarin in healthy men”. Therapeutic Drug Monitoring 2 (1989): 176-184.