{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T15:45:07Z","timestamp":1770997507566,"version":"3.50.1"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In contrast to overanticoagulation, evidence on risk factors and outcome of subtherapeutic oral anticoagulation (OAC) with vitamin K-antagonists (VKAs) under optimum care is limited. We investigated the clinical phenotype, anticoagulation control, and clinical outcome of 760 VKA patients who received OAC therapy by a specialized coagulation service in the thrombEVAL study (NCT01809015). During 281,934 treatment days, 278 patients experience \u2265 1 episode of subtherapeutic anticoagulation control and had lower quality of OAC therapy compared to 482 patients without subtherapeutic international normalized ratio: 67.6%, interquartile range (IQR) 54.9%\/76.8% versus 81.0%, IQR 68.5%\/90.4%; p\u2009&lt;\u20090.001. In Cox regression analysis with adjustment for age, sex, cardiovascular risk factors, comorbidities, and treatment characteristics, female sex (hazard ratio [HR], 1.4, 95% confidence interval [CI], 1.0\/1.9; p\u2009=\u20090.03), diabetes (HR, 1.4, 95% CI, 1.0\/2.0; p\u2009=\u20090.03), and living alone (HR, 1.5, 95% CI, 1.1\/2.1; p\u2009=\u20090.009) were independent risk factors of subtherapeutic anticoagulation control, whereas atrial fibrillation (HR, 0.6, 95% CI, 0.4\/0.9; p\u2009=\u20090.02) and self-management of OAC therapy (HR, 0.2, 95% CI, 0.1\/0.6; p\u2009=\u20090.001) were protective. In addition, active smoking (HR, 1.7, 95% CI, 0.9\/3.0; p\u2009=\u20090.086) and living in a nursing home (HR, 1.6, 95% CI, 0.8\/3.2; p\u2009=\u20090.15) indicated an elevated risk at the borderline of statistical significance. For the prediction of recurrent subtherapeutic anticoagulation, living alone was the only independent risk factor (HR, 1.7, 95% CI, 1.1\/2.5; p\u2009=\u20090.013). The present study suggests that women, diabetics, and patients living alone experience an increased risk of low-quality VKA therapy and might potentially benefit from treatment with direct-acting anticoagulants.<\/jats:p>","DOI":"10.1055\/s-0039-1692175","type":"journal-article","created":{"date-parts":[[2019,6,11]],"date-time":"2019-06-11T15:58:25Z","timestamp":1560268705000},"page":"1347-1357","source":"Crossref","is-referenced-by-count":10,"title":["Subtherapeutic Anticoagulation Control under Treatment with Vitamin K-Antagonists\u2014Data from a Specialized Coagulation Service"],"prefix":"10.1055","volume":"119","author":[{"given":"J\u00fcrgen H.","family":"Prochaska","sequence":"additional","affiliation":[{"name":"Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany"},{"name":"Center for Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site RhineMain, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Hausner","sequence":"additional","affiliation":[{"name":"Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Nagler","sequence":"additional","affiliation":[{"name":"Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany"},{"name":"Center for Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"G\u00f6bel","sequence":"additional","affiliation":[{"name":"Center for Cardiology\u2013Cardiology I, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site RhineMain, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Eggebrecht","sequence":"additional","affiliation":[{"name":"Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Panova-Noeva","sequence":"additional","affiliation":[{"name":"Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany"},{"name":"Center for Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site RhineMain, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Arnold","sequence":"additional","affiliation":[{"name":"Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Lauterbach","sequence":"additional","affiliation":[{"name":"Department of Medicine 3, Barmherzige Br\u00fcder Hospital Trier, Trier, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Bickel","sequence":"additional","affiliation":[{"name":"Department of Medicine I, Federal Armed Forces Central Hospital, Koblenz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Michal","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Hardt","sequence":"additional","affiliation":[{"name":"Center for General Medicine and Geriatrics, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Espinola-Klein","sequence":"additional","affiliation":[{"name":"Center for Cardiology\u2013Cardiology I, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl J.","family":"Lackner","sequence":"additional","affiliation":[{"name":"Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site RhineMain, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"M\u00fcnzel","sequence":"additional","affiliation":[{"name":"Center for Cardiology\u2013Cardiology I, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site RhineMain, Mainz, Germany"},{"name":"Center for Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp S.","family":"Wild","sequence":"additional","affiliation":[{"name":"Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany"},{"name":"Center for Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site RhineMain, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2019,6,10]]},"container-title":["Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0039-1692175.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,8,5]],"date-time":"2019-08-05T06:06:07Z","timestamp":1564985167000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0039-1692175"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,10]]},"references-count":0,"journal-issue":{"issue":"08","published-online":{"date-parts":[[2019,8,2]]},"published-print":{"date-parts":[[2019,8]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0039-1692175","relation":{},"ISSN":["0340-6245","2567-689X"],"issn-type":[{"value":"0340-6245","type":"print"},{"value":"2567-689X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,10]]}}}