Accuracy of a Portable Prothrombin Time Monitor (Coagucheck) in Patients on Chronic Oral Anticoagulant Therapy

Cosmi, Benilde; Palareti, Gualtiero; Moia, Marco; Carpenedo, Monica; Pengo, Vittorio; Biasiolo, Alessandra; Rampazzo, Patrizia; Morstabilini, Giampietro; Testa, Sophie

doi:10.1016/s0049-3848(00)00323-6

Cited by 46 publications

(34 citation statements)

References 11 publications

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“…Unlike the newer instruments available, it cannot perform simultaneous quality control. The CV of this device appears to range from 3% to 7% [50][51][52]. In a recent report, the accuracy of this device, when compared to laboratory methods, showed a mean INR bias of negative 0.025, with the least amount of bias at INRs between 2.0 and 3.0 [52].…”

Section: Coaguchek Systemmentioning

confidence: 80%

“…The CV of this device appears to range from 3% to 7% [50][51][52]. In a recent report, the accuracy of this device, when compared to laboratory methods, showed a mean INR bias of negative 0.025, with the least amount of bias at INRs between 2.0 and 3.0 [52]. Another study demonstrated that there was no significant difference between the geometric mean INRs obtained from the CoaguChek system and laboratory systems [53].…”

Section: Coaguchek Systemmentioning

confidence: 87%

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Home prothrombin time monitoring: A literature analysis

2004

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The anticoagulant activity of warfarin sodium is monitored by the prothrombin time (PT) using the international normalized ratio (INR). Standard oral anticoagulant therapy monitoring requires frequent patient visits to physicians' offices and/or laboratories to optimize warfarin dosage. Home PT monitoring by patients can increase testing frequency and may thus decrease complications associated with oral anticoagulant therapy. Clinical studies suggest that home PT monitoring is more effective than uncoordinated management and is as effective as care through specialized anticoagulation clinics for keeping INRs within a therapeutic range. There are accurate and reliable instruments available, but paramount to the success of home PT monitoring is sound patient selection, appropriate patient training, and consistent quality control. Am.

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Section: Coaguchek Systemmentioning

confidence: 80%

Section: Coaguchek Systemmentioning

confidence: 87%

Home prothrombin time monitoring: A literature analysis

2004

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“…12,13 In these studies, the quality of INR control did not differ between POC and standard monitoring methods. 12,14 Hence, POC devices are considered to be a reliable and effective alternative for outpatient monitoring of long-term anticoagulation. 11,13,20 In contrast, data regarding the use of INR POC devices in emergency departments are very limited.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13][14] The precision of POC measurements in the emergency setting of acute stroke, however, is largely unknown. Importantly, the time gain for stroke patients who are candidates for thrombolysis by using POC has not been investigated to date.…”

mentioning

confidence: 99%

Point-of-Care International Normalized Ratio Testing Accelerates Thrombolysis in Patients With Acute Ischemic Stroke Using Oral Anticoagulants

Rizos

Herweh

Jenetzky

et al. 2009

Stroke

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Background and Purpose-Thrombolysis in patients using oral anticoagulants (OAC) and in patients for whom information on OAC status is not available is frequently delayed because the standard coagulation analysis procedure in central laboratories (CL) is time-consuming. By using point-of-care (POC) coagumeters, international normalized ratio (INR) values can be measured immediately at the bedside. The accuracy and effectiveness of POC devices for emergency management in acute ischemic stroke has not been tested. Methods-In phase 1, the reliability of emergency INR POC measurements in comparison to CL was determined. In phase 2, patients with ischemic stroke admitted within the time frame for systemic thrombolysis and who were either using OAC or for whom information on OAC status was not available were enrolled. Patients received thrombolysis if POC INR was Յ1.5. Precision and time gain was recorded for INR as measured by POC vs CL. Results-In phase 1 (nϭ113), Bland-Altman analysis showed close agreement between POC and CL, and Pearson correlation was highly significant (rϭ0.98; PϽ0.01). In phase 2, 48 patients were included, of whom 70.8% were using OAC; 23 patients received thrombolysis. After subtracting the time needed for the diagnostic work-up, the net time gain was 28Ϯ12 minutes (meanϮSD).

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“…The current study identified an excellent correlation between the POC and the SCA INR, similar to that shown in previous studies. This finding demonstrates that the POC device is accurate, reliable and comparable to the SCA INR for use in patients with long-term use of oral anticoagulants 4,5,8,10 . POC could be useful in several situations, as patients without access to a medical laboratory could achieve better control with OAT 6 ; and in patients with acute IS who are within the therapeutic window for thrombolysis, evaluating INR using POC could be performed in the pre-hospital emergency medical service or in the hospital emergency room, reducing the time to treatment.…”

Section: Discussionmentioning

confidence: 56%

Is point-of-care accurate for indicating thrombolysis in anticoagulated patients on oral anticoagulation treatments?

Bruch

Mendes

Pedrozo

et al. 2014

Arq. Neuro-Psiquiatr.

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The use of oral anticoagulation treatment (OAT) in patients with an international normalized ratio (INR) higher than 1.7 is a contraindication to thrombolysis in acute ischemic stroke. The aim of the present study is to compare the use of point-of-care (POC) coagulometers to the standard coagulation analysis (SCA) procedure of the INR as a decision-making test for use with patients taking OAT. Method: Eighty patients on chronic OAT underwent a POC and an SCA during a regular outpatient evaluation. Results: When comparing the abilities of the POC test and the SCA test to identify adequate levels for thrombolysis (#1.7), the POC had a sensitivity of 96.6% (95%CI 88.4-99.1) and a specificity of 60.0% (95%CI 38.6-78). POC overestimated INR levels by 0.51 points compared to the SCA test. Conclusion: POC has a high sensitivity compared to the SCA test for the identification of patients within the cut-off point for thrombolysis.Keywords: ischemic stroke, thrombolytic therapy, warfarin, contraindications, anticoagulation. RESUMOValores acima de 1.7 no RNI de pacientes em uso de terapia anticoagulante (ACO) é uma contraindicação para a trombólise no AVC isquêmico. O Objetivo do presente estudo é comparar o teste capilar rápido (TCR) com o exame tradicional de RNI como método de decisão para indicação de terapia trombolítica em pacientes em uso de ACO. Método: Oitenta pacientes em uso crônico de ACO foram submetidos ao TCR e ao exame tradicional durante consulta ambulatorial. Resultados: Ao serem comparados os resultados do TCR com o exame tradicional com o ponto de corte de 1,7 de RNI, o teste rápido teve sensibilidade de 96,6% (IC95% 88,4-99,1) e especificidade de 60,0% (IC95% 38,. O TCR superestimou os níveis de RNI em 0,51 pontos comparado ao exame tradicional. Conclusão: O TCR apresentou elevada sensibilidade, comparado ao exame tradicional para a identificação de pacientes em uso de ACO com indicação de trombólise.Palavras-chave: acidente vascular cerebral, terapia trombolítica, testes de coagulação sanguínea, varfarina, antagonistas da vitamina K, anticoagulação oral.

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Accuracy of a Portable Prothrombin Time Monitor (Coagucheck) in Patients on Chronic Oral Anticoagulant Therapy

Cited by 46 publications

References 11 publications

Home prothrombin time monitoring: A literature analysis

Home prothrombin time monitoring: A literature analysis

Point-of-Care International Normalized Ratio Testing Accelerates Thrombolysis in Patients With Acute Ischemic Stroke Using Oral Anticoagulants

Is point-of-care accurate for indicating thrombolysis in anticoagulated patients on oral anticoagulation treatments?

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