Controle do tempo de protrombina em sangue capilar e venoso em pacientes com anticoagulação oral: correlação e concordância

Leiria, Tiago Luiz Luz; Pellanda, Lúcia Campos; Magalhães, Eros; Lima, Gustavo Glotz de

doi:10.1590/s0066-782x2007001300001

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…These show diverse conclusions regarding the disadvantages and discrepancies in INR results, as described above. 43,[47][48][49][50][51][52] Often these results are sufficiently different to alter clinical decisions related to adjusting oral anticoagulant therapy in patients. [39][40][41] The recall by the FDA in 2016 of one POCT INR device used in the pivotal ROCKET-AF trial highlights the problem.…”

Section: Point-of-care Testing: Inr Monitoringmentioning

confidence: 99%

Point-of-care testing : is it a paradox in international normalised ratio measurements?

Maule

2020

The Journal of Medical Laboratory Science and Technology of Sou

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Point-of-care testing (POCT) in haemostasis has shown a steady state increase in the range of tests available with an exponential increase in the number of tests that are performed annually. The most commonly performed test remains the out of hospital measurement of the international normalised ratio (INR). The INR is used to monitor oral anticoagulation therapy (OAT) with vitamin K antagonists. Such drugs include some of the following: warfarin (Coumadin®), phenprocoumon (Marcumar®) and acenocoumarol (Sintrom®, also sold as other brand names). Contrary to laboratory testing, POCT is often performed by general practitioners (GPs), nurses, pharmacists, patients and other healthcare professionals. In many cases these individuals do not have access to the same support mechanisms that exist in the clinical laboratory regarding strict quality control programmes. When an INR test is performed in the clinical laboratory, it has to be accredited, monitored and inspected. Accreditation is also advisable and part of these requirements is to be involved in external quality assessment (EQA). In the case of POCT haemostasis assays, EQA programmes do exist, however these programmes are still relatively few in number. Over the last decade there has been a significant increase in the scope of POCT, particularly in the field of haemostasis. This brief review summarises POCT in haemostasis, highlighting some of its benefits, challenges and future perspectives, especially with regard to the measurement of the INR.

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Section: Point-of-care Testing: Inr Monitoringmentioning

confidence: 99%

Point-of-care testing : is it a paradox in international normalised ratio measurements?

Maule

2020

The Journal of Medical Laboratory Science and Technology of Sou

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“…The routine use of oral anticoagulants is related to hemostatic imbalance between clotting and blood anticoagulation, and significant variations in this relationship may increase the risk of hemorrhage or thromboembolism (Dahlback, 2000; Leiria et al, 2007; Barco et al, 2013; Harter et al, 2015; Yeh et al, 2015; Gerzson et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Bleeding Risk in Patients Using Oral Anticoagulants Undergoing Surgical Procedures in Dentistry: A Systematic Review and Meta-Analysis

et al. 2019

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The management of patients who undergo dental surgical procedures and receive oral anticoagulant therapy requires particular attention due to the risk of bleeding that may occur during the procedure. Bleeding rates in these trans- or post-operative patients tend to be unpredictable. The aim of this study was to conduct a systematic review in order to assess the risk of bleeding during and after performing oral surgery in patients administered oral anticoagulants compared with a group that discontinued anticoagulant therapy. For the purposes of this review, we searched the databases of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE ( via Ovid), EMBASE ( via Ovid), and the Virtual Health Library (VHL) from inception of the database to December 2018. The primary outcome was defined as the occurrence of local bleeding during and after oral surgical procedures. Four reviewers, independently and in pairs, screened titles and abstracts for full-text eligibility. Data regarding participant characteristics, interventions, and design and outcomes of the included studies were extracted. The data were pooled using random-effects meta-analyses and described as risk ratios (RRs) with a 95% confidence interval (95% CI). The confidence for the pooled estimates was ascertained through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, and the protocol of this review was recorded in PROSPERO (CRD42017056986). A total of 58 eligible studies were identified, of which three randomized controlled trials were included in the meta-analysis, covering a total of 323 adult participants, among whom 167 were taking anticoagulants at the time they underwent dental surgery. Of these patients, 14.2% had reported bleeding. The risk of bleeding was found to be one to almost three times greater in patients taking warfarin compared with patients who discontinued the use of anticoagulant during the trans-operative period (RR = 1.67, 95% CI = 0.97 to 2.89) and in the post-operative period (RR = 1.44, 95% CI = 0.71 to 2.92), although the quality of evidence was very low. The results indicate that there is no evidence that the use of anticoagulants eliminates the risk of bleeding during surgical dental procedures.

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“…The use of oral anticoagulants has been indicated for the prevention of thromboembolism in patients suffering from heart diseases such as ischaemic cardiac disease, atrial fibrillation and patients with prosthetic heart valves, among others. 1 2 …”

Section: Introductionmentioning

confidence: 99%

Bleeding risk in patients using oral anticoagulants submitted to surgical procedures in dentistry: a systematic review protocol

et al. 2017

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IntroductionThe management of patients undergoing oral surgical procedures using anticoagulants raises concerns regarding the risk of bleeding. Bleeding rates in those patients during or after oral surgical procedures are uncertain. The aim of this study will be to determine the bleeding rate during and after oral surgeries in patients using anticoagulants.Methods and analysisA systematic review will be conducted and if appropriate, a meta-analysis of randomised clinical trials evaluating the bleeding risk during and after oral surgical procedures in patients using anticoagulants were selected. The literature search will be conducted using electronic databases, such as the Cochrane Central Register of Controlled Trials, MEDLINE (via Ovid), Embase (via Ovid), Cumulative Index to Nursing and Allied Health Literature (via Ovid), LILACS (SciELO) and CAPES database, without restriction of languages or date of publication. The primary outcome will be the occurrence of local bleeding rate during and after oral surgical procedures, and as secondary outcome, the following complications will be considered: implant failure, healing problems and infections. Groups of two independent reviewers will select the titles and abstracts for full-text eligibility. For eligible studies, the same reviewers will perform data extraction, bias risk assessment and determination of the overall quality of evidence for each of the outcomes using the Grading of Recommendations Assessment, Development and Evaluation classification system. Meta-analysis and subgroup analyses will be conducted, to all outcomes, if appropriate.Ethics and disseminationThe systematic review will be published in a peer-reviewed journal, and brief reports of the review’s findings will be released directly to the intended audience. The results will help dentists in the decision-making process to minimise the risk of bleeding in patients using anticoagulants in their clinical practice.PROSPERO registration numberCRD42017056986.

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Controle do tempo de protrombina em sangue capilar e venoso em pacientes com anticoagulação oral: correlação e concordância

Cited by 4 publications

References 20 publications

Point-of-care testing : is it a paradox in international normalised ratio measurements?

Point-of-care testing : is it a paradox in international normalised ratio measurements?

Bleeding Risk in Patients Using Oral Anticoagulants Undergoing Surgical Procedures in Dentistry: A Systematic Review and Meta-Analysis

Bleeding risk in patients using oral anticoagulants submitted to surgical procedures in dentistry: a systematic review protocol

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