O Mundo da Saúde (Aug 2021)
Analysis of the CHA2DS2-VASc score in patients with inadequate anticoagulation control
Abstract
Among the tools for assessing the risk of thromboembolic events, the CHA2DS2-VASc score stands out, which contributes to the identification of patients that are eligible for the use of anticoagulant therapy, which is a great aid in thromboembolic prophylaxis. The present study aims to characterize patients with inadequate control of anticoagulation according to their CHA2DS2-VASc score. Information was collected from patients being followed up at an anticoagulation clinic associated with a teaching hospital in Minas Gerais. Patients accompanied at the clinic between August and December 2017, taking warfarin for at least 180 days, with a chronic indication for anticoagulation, and with at least values from two results of the International Normalized List (INR) test were included. 434 patients were identified and 202 with inadequate anticoagulation control. For patients with inadequate control, the CHA2DS2-VASc was calculated, which is performed by the sum of risk factor scores for thromboembolic events. Patients were classified as low (0 points), moderate (1 point), or high (≥ 2 points) risk. An association was also made between the score and variables that characterize the context of the patients, such as the municipality of residence and the target therapeutic range of the INR. It is noteworthy that 107 (53.0%) had hypertension; 96 (47.5%) had peripheral arterial, coronary or aortic disease; 62 (30.7%) had a previous stroke; and 27 (13.4%) had diabetes. A considerable percentage of patients with CHA2DS2-VASc ≥ 2 (n = 191; 94.5%) was identified, which indicates a high risk for the occurrence of thromboembolic events and reinforces the importance of adequate anticoagulant pharmacotherapy. Regarding the association between demographic characteristics and the results of the CHA2DS2-VASc score, an association was identified between the CHA2DS2-VASc score and city of residence (p0.05).
