Time in the Therapeutic Range for Patients Taking Acenocoumarol at the University Hospital Establishment of Oran in Algeria

Abstract

Aims: Acenocoumarol, a vitamin K antagonist anticoagulant, is used in the management of common thromboembolic conditions, such as atrial fibrillation and venous thrombosis. Although it remains a standard treatment in Algeria, its clinical use is hampered by significant interindividual variability in therapeutic response, influenced by several genetic and non-genetic factors. the objective of this work was to evaluate the quality of anticoagulation with acenocoumarol at the University and Hospital Establishment of Oran, Algeria. Methodology: A prospective descriptive cross-sectional study was conducted on patients treated with acenocoumarol. Therapeutic monitoring was performed using the International Normalized Ratio (INR) and the Time in Therapeutic Range (TTR). Results and Discussion: A total of 51 patients were followed. The results showed a female predominance, with a mean age of 55 ± 2.33 years. The mean daily dose of acenocoumarol administered was 2.52 ± 0.7 mg/ day, and the steady-state dose was 2.72 ± 0.89 mg/day; the mean time to steady state was 2.72 ± 0.89 days. Only 41.18% of patients achieved their INR target at the end of the study. The majority of patients (82.35%) had a TTR below 50%, indicating poor control of anticoagulation with acenocoumarol. Conclusion: This study has demonstrated that acenocoumarol dosage optimization by INR is insufficient, and has highlighted the importance of implementing other dosage personalization approaches such as pharmacogenetics.