Time in the Therapeutic Range for Patients Taking Acenocoumarol at the University Hospital Establishment of Oran in Algeria
Habiba Fetati *
Pharmacovigilance Department, University Hospital Establishment 1st November 1954, BP N° 4166 Ibn Rochd 31000, Oran, Algeria and Pharmacy Department, University Oran 1 Ahmed Ben Bella, Faculty of Medicine, Research Laboratory in Pharmaceutical Development, B.P 1510 El M'Naouer 31000, Oran, Algeria.
Nadjet Fatima Zohra Mekaouche
Pharmacovigilance Department, University Hospital Establishment 1st November 1954, BP N° 4166 Ibn Rochd 31000, Oran, Algeria and Pharmacy Department, University Oran 1 Ahmed Ben Bella, Faculty of Medicine, Research Laboratory in Pharmaceutical Development, B.P 1510 El M'Naouer 31000, Oran, Algeria.
Fatma Boudia
Pharmacovigilance Department, University Hospital Establishment 1st November 1954, BP N° 4166 Ibn Rochd 31000, Oran, Algeria and Pharmacy Department, University Oran 1 Ahmed Ben Bella, Faculty of Medicine, Research Laboratory in Pharmaceutical Development, B.P 1510 El M'Naouer 31000, Oran, Algeria.
Asmaa Memou
Pharmacovigilance Department, University Hospital Establishment 1st November 1954, BP N° 4166 Ibn Rochd 31000, Oran, Algeria and Pharmacy Department, University Oran 1 Ahmed Ben Bella, Faculty of Medicine, Research Laboratory in Pharmaceutical Development, B.P 1510 El M'Naouer 31000, Oran, Algeria.
Saleh Asma
Pharmacy Department, Faculty of Medicine, Abdelhamid Ibn Badis University, Site III (formerly ITA), 27000 Mostaganem, Algeria.
Amara Nihad
Pharmacovigilance Department, University Hospital Establishment 1st November 1954, BP N° 4166 Ibn Rochd 31000, Oran, Algeria and Pharmacy Department, University Oran 1 Ahmed Ben Bella, Faculty of Medicine, Research Laboratory in Pharmaceutical Development, B.P 1510 El M'Naouer 31000, Oran, Algeria.
Chadou Hacene
Pharmacovigilance Department, University Hospital Establishment 1st November 1954, BP N° 4166 Ibn Rochd 31000, Oran, Algeria and Pharmacy Department, University Oran 1 Ahmed Ben Bella, Faculty of Medicine, Research Laboratory in Pharmaceutical Development, B.P 1510 El M'Naouer 31000, Oran, Algeria.
Melissa Chabane
Pharmacovigilance Department, University Hospital Establishment 1st November 1954, BP N° 4166 Ibn Rochd 31000, Oran, Algeria and Pharmacy Department, University Oran 1 Ahmed Ben Bella, Faculty of Medicine, Research Laboratory in Pharmaceutical Development, B.P 1510 El M'Naouer 31000, Oran, Algeria.
Achir Nafisa
Pharmacovigilance Department, University Hospital Establishment 1st November 1954, BP N° 4166 Ibn Rochd 31000, Oran, Algeria and Pharmacy Department, University Oran 1 Ahmed Ben Bella, Faculty of Medicine, Research Laboratory in Pharmaceutical Development, B.P 1510 El M'Naouer 31000, Oran, Algeria.
Bellil Amina
Département de Pharmacied’Oran, Faculty of Medicine, University Oran 1 Ahmed Ben Bella, Algeria.
Bendjilali Hind
Département de Pharmacied’Oran, Faculty of Medicine, University Oran 1 Ahmed Ben Bella, Algeria.
Soulimane Rym
Cardiology Department, University Hospital Establishment 1st November 1954, BP N° 4166 Ibn Rochd 31000, Oran, Algeria.
Houari Toumi
Pharmacovigilance Department, University Hospital Establishment 1st November 1954, BP N° 4166 Ibn Rochd 31000, Oran, Algeria and Pharmacy Department, University Oran 1 Ahmed Ben Bella, Faculty of Medicine, Research Laboratory in Pharmaceutical Development, B.P 1510 El M'Naouer 31000, Oran, Algeria.
*Author to whom correspondence should be addressed.
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.
Keywords: Oral anticoagulation, therapeutic monitoring, time in therapeutic range ratio, TTR