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Portable prothrombin time (PT) monitors offer the potential for both simplifying and improving oral anticoagulation management. It is necessary to evaluate their concordance and correlation with other PT systems. Our objective was to evaluate the concordance and clinical correlation of two portable PT determination systems, ProTime (ITC) and CoaguChek S (Roche Diagnostics). In all, 20 healthy individuals and 60 anticoagulated patients stabilized over 3 months in a therapeutic International Normalized Ratio (INR) range between 2-3.5 were studied. A drop of capillary blood was obtained simultaneously from two different fingers of each patient and applied to the monitor's application zone. The mean INR of the patients' blood samples of the two monitors differed by 0.01 units (2.32+/-0.63 for Pro Time and 2.33+/-0.68 for CoaguChek). The percentage of simple concordance and the kappa index were 88.3 and 75.9%, respectively. The coefficient of correlation was 0.922. The mean difference (bias) between the monitors was 0.01. The portable PT monitors evaluated presented a high percentage of concordance in INR results.

Self-testing of oral anticoagulation is a new possibility related to the development of portable capillary whole blood prothrombin time monitors. The aim of this study was to evaluate one of this monitors, Coaguchek^®, with respect to its comparability with our routine prothrombin time determination system, as well as with the reference manual technique and two thromboplastins of high sensitivity, Manchester Reagent and one manufactured in our center, Thromboplastin Bilbao, in a group of patients on oral anticoagulant treatment. Although a correlation of r = 0.9271 was found between international normalized ratio (INR) values of Coaguchek and our routine method, Neoplastine/STA analyzer, the difference of the INR scatter increased with the magnitude of measurement, being lowest for INR between the portable monitor and Manchester Reagent and Thromboplastin Bilbao, with a similar coefficient of correlation, r = 0.8948 and r = 0.8905, respectively. A test was performed showing a 65.6% agreement with the INR values of the STA analyzer, 66.4% with Manchester Reagent and 73.4% with Thromboplastin Bilbao. On the basis of this correspondence with laboratory prothrombin time results Coaguchek may be considered as a possible option for monitoring anticoagulated patients even though patients should be given instructions and advice as regards the management and interpretation of the results.

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The aim of this study was to evaluate the accuracy of the portable coagulometer CoaguChek^® (Roche Diagnostics) as a prothrombin time (PT) monitor, and to correlate capillary blood results with those of three different routine methods used for monitoring oral anticoagulant therapy (OAT): capillary, plasma and whole blood samples. Three hospitals participated in the study with a total of 235 patients on OAT. The international normalized ratio (INR) results obtained with CoaguChek were compared with those obtained using each of the routine methods. The study presents a good correlation between the PT monitor and the three methods studied: r = 0.9745 (hospital A), r = 0.9283 (hospital B), r = 0.9136 (hospital C). A simplified concordance test of the methods results in a nine-field comparison table showing concordances of 87.2, 85.7 and 68.4%, respectively. The absolute difference (mean ± SD) between laboratory A and CoaguChek INRs was 0.0571 ± 0.2042, with values of 0.04286 ± 0.3906 for laboratory B and 0.6986 ± 0.6170 for laboratory C. These results confirm that CoaguChek could be used as a new method for oral anticoagulant monitoring, and is in best agreement with the capillary blood PT system.

Objective: To determine the possible differences in lipid, thrombogenic and inflammatory marker concentrations and the presence of chronic and acute coronary artery disease (stable and unstable angina, respectively), comparing them with a group of control patients with normal coronary arteries. Material and Methods: This prospective cohort study included 125 patients with unstable angina, 189 with stable angina and a control group of 83 patients with normal coronary arteries. Marker concentrations were measured in all 3 groups. Logistic regression analysis was performed to determine whether such factors could predict unstable or stable angina. Results: Lipid parameter concentrations were similar in the 2 coronary disease groups and significantly lower than in controls. Haemostatic and inflammatory marker concentrations were higher in patients with coronary disease, but were statistically significant only when comparing unstable angina patients with normal controls. Unstable angina patients had significantly higher levels of lipoprotein (a) [Lp(a)], fibrinogen, C-reactive protein (CRP) and leucocytes. Multiple logistic regression analysis showed that CRP (OR 2.635, 95% CI 1.417–4.898), smoking (OR 3.416, 95% CI 1.773–6.584), leucocytes (OR 2.034, 95% CI 1.079–3.836) and Lp(a) (OR 2.269, 95% CI 1.188–4.334) were independent risk factors of unstable versus stable angina. Conclusions: Patients with unstable angina present a more atherogenic profile than patients with stable angina. Together with smoking, elevated Lp(a), CRP and leucocyte concentrations proved to be associated with the presence of unstable angina.

The aim of this work was to investigate the relationship between different lipids parameters with presence and severity of coronary obstruction angiographically evaluated. 897 patients (629 men and 268 women) underwent an angiography and blood extraction to determine concentrations of lipid markers: total cholesterol (TC), HDL cholesterol (HDLc), triglycerides, LDL cholesterol (LDLc), apolipoprotein A1 (apoA1), apolipoprotein B100 (apoB), non-HDL cholesterol and total cholesterol/HDLc, apoB100/apoA1 and LDLc/HDLc ratios. Multivariate analysis revealed that low HDLc levels were independently associated with the presence of coronary obstruction (OR: 0.982, 95% CI 0.969–0.996). In relation to severity of coronary stenosis, only apoA1 levels (OR: 0.990, 95% CI 0.980–1.000) and apoB/apoA1 ratio (OR: 3.243, 95% CI 1.095–9.608) were independent predictors. Our study demonstrated that HDLc was the only lipid parameter negatively and significantly associated with the presence of coronary obstruction, whereas apoA1 levels and apoB/apoA1 ratio were independent predictors of stenosis severity.