Viana Catiane Costa, Praxedes Marcus Fernando da Silva, Abreu Mauro Henrique Nogueira Guimarães de, Sousa Waleska Jaclyn Freitas Nunes de, Ferreira Cássia Rodrigues Lima, Campos Emílio Itamar de Freitas, Silva José Luiz Padilha da, Martins Maria Auxiliadora Parreiras
Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil.
Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia, Santo Antônio de Jesus 44430-622, Bahia, Brazil.
Int J Environ Res Public Health. 2025 Jan 6;22(1):65. doi: 10.3390/ijerph22010065.
Evidence indicates a difference between men and women in oral anticoagulation control, but the results were discrepant. This study investigated the association of sex with oral anticoagulation control in patients on warfarin assisted by anticoagulation clinics (ACs) in Brazil. The cross-sectional study included patients on warfarin recruited at three public ACs in southeast Brazil (2014-2015). The quality of oral anticoagulation was estimated by the time in therapeutic range (TTR). Univariable and multivariable linear regression models were built to examine the association of sociodemographic, behavior, clinical, and drug therapy variables with TTR. Overall, 801 participants were studied (455; 56.8% women), with a mean age of 65.0 (13.4) years. The female sex was associated with lower TTR than the male sex (Beta (95% CI) = -17.01 (-30.25; -3.76), = 0.012), however, this difference decreased with increasing age, becoming null after age 60. Smoking patients had a lower TTR than non-smokers (-5.18 (-10.02; -0.34), = 0.036). The results showed that the association of sex with oral anticoagulation control is dependent on age. Women have lower TTR than men, but this difference is null in older patients. Knowledge of these factors may be useful for developing strategies to improve care for these patients.
有证据表明，男性和女性在口服抗凝控制方面存在差异，但结果并不一致。本研究调查了在巴西抗凝诊所（ACs）接受华法林治疗的患者中，性别与口服抗凝控制之间的关联。这项横断面研究纳入了在巴西东南部三家公立ACs招募的服用华法林的患者（2014 - 2015年）。口服抗凝质量通过治疗范围内时间（TTR）来评估。建立了单变量和多变量线性回归模型，以检验社会人口统计学、行为、临床和药物治疗变量与TTR之间的关联。总体而言，共研究了801名参与者（455名女性，占56.8%），平均年龄为65.0（13.4）岁。女性的TTR低于男性（β（95%CI）= -17.01（-30.25；-3.76），P = 0.012），然而，这种差异随着年龄的增加而减小，在60岁后消失。吸烟患者的TTR低于非吸烟患者（-5.18（-10.02；-0.34），P = 0.036）。结果表明，性别与口服抗凝控制之间的关联取决于年龄。女性的TTR低于男性，但在老年患者中这种差异消失。了解这些因素可能有助于制定改善这些患者护理的策略。
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