Comparison of INR stability between self-monitoring and standard laboratory method: Preliminary results of a prospective study in 67 mechanical heart valve patients

Dauphin, Claire; Legault, B; Jaffeux, P.; Motreff, Pascal; Azarnoush, Kasra; Joly, Hélène; Geoffroy, Etienne; Aublet-Cuvelier, Bruno; Camilleri, Lionel; Lusson, Jean-René; Cassagnes, J; Riberolles, C. De

doi:10.1016/j.acvd.2008.10.007

Cited by 28 publications

(13 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Smaller variations in INR values in these patients taking warfarin are associated with improved survival 34. Consistent INRs can be achieved with the use of point-of-care home testing which makes vitamin K antagonist therapy safer 35. Increased use of these devices may make outcomes after mechanical heart valve implantation more convenient and safer.…”

Section: Futurementioning

confidence: 99%

Results of mechanical versus tissue AVR: caution in young patients with tissue AVR

Briffa

2019

Heart

View full text Add to dashboard Cite

The first aortic valve prosthesis, implanted more than 50 years ago, was a mechanical prosthesis (ball-and-cage design). Over the ensuing decades, tissue prostheses and new mechanical designs were introduced to mitigate the need for anticoagulation with its associated side effects. Tissue and mechanical heart valve prostheses were compared in two head-to-head randomised control trials. Both of these confirmed that mechanical prostheses were durable but patients suffered anticoagulant-related bleeds. Patients who received a tissue prosthesis were more likely to suffer prosthetic dysfunction and require reoperation. This trend was stronger in younger patients. Since the publication of those two trials, several large retrospective studies using data from meta-analyses of published papers or registries have failed to show a survival advantage of either prostheses when implanted in the aortic position in younger patients. This equipoise has been reflected in the heart valve disease guidelines published by European and US societies. In recent years, the primacy of patient choice, the rapid increase in life expectancy of populations, the increased incidence of atrial fibrillation with requirement for anticoagulation, the advent of transcatheter techniques to treat degenerating tissue valves as well as advances in anticoagulant therapy and in new tissue and to a lesser extent mechanical prosthetic design continue to influence choice of aortic valve prosthesis in younger patients undergoing aortic valve replacement.

show abstract

Section: Futurementioning

confidence: 99%

Results of mechanical versus tissue AVR: caution in young patients with tissue AVR

Briffa

2019

Heart

View full text Add to dashboard Cite

show abstract

“…Перспективным является обучение пациентов методам самотестирования и самоконтроля МНО с помощью портативных аппаратов [10,11], ис-пользование которых повышает приверженность к лечению и уменьшает частоту возникновения геморрагических и тромботических осложнений [12][13][14][15][16] в результате стабилизации целевого диа-пазона МНО [17,18].…”

Section: централизованная система контроля мноunclassified

Introduction of Centralized Inr Control in Kuzbass

Горбунова¹,

Макаров²,

Барбараш³

2016

Kompleks. probl. serdečno-sosud. zabol.

View full text Add to dashboard Cite

Цель. Обосновать целесообразность внедрения системы централизованного контроля международного нормализованного отношения (МНО) в Кузбасском регионе.Анализ литературных данных свидетельствует, что централизованный контроль МНО увеличивает время нахождения в те-рапевтическом диапазоне, улучшает качество контроля, уменьшает частоту госпитализаций по причине кровотечений и тромбо-эмболий.Выводы. Организация антикоагулянтных кабинетов является экономически эффективной альтернативой лабораторного контроля МНО и может быть рекомендована для внедрения в практическое здравоохранение.Ключевые слова: централизованный контроль, международное нормализованное отношение, антикоагулянтный кабинет, экономическая эффективность. INTRODUCTION OF CENTRALIZED INR CONTROL IN KUZBASS E. V. GORBUNOVA, S. A. MAKAROV, O. L. BARBARASH Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases. Kemerovo, RussiaPurpose. Warfarin, an indirect anticoagulant, is commonly prescribed to patients who are at high risk for thrombotic complications. the achieved target hypocoagulation range allows to prevent thrombotic and hemorrhagic complications. Centralized international normalized ratio (INR) control increases the time in therapeutic range, improves quality control, reduces the rate of hospitalizations for bleeding and thromboembolism, suggesting its economic efficiency and allows to recommend this method of INR control for practical use. the current article presents the rationale for implementing centralized IRN control in the Kuzbass region in order to improve the efficiency and safety of ACt.

show abstract

“…Most of the non-U.S. studies evaluated the feasibility and efficacy of PSM, and this is the most common approach applied today in practice in Europe. 34 Only a few non-U.S. studies 41,54,73 evaluated PST without dose management. In the two studies that compared PST with PSM, 51, 74 no major differences in outcomes were noted.…”

Section: Studies Performed Outside the United Statesmentioning

confidence: 99%

Anticoagulation Patient Self‐Monitoring in the United States: Considerations for Clinical Practice Adoption

et al. 2011

View full text Add to dashboard Cite

Systematic management models such as anticoagulation clinics have emerged in order to optimize warfarin effectiveness and to minimize related complications. Most of these models are structured so that patients come to a clinic for in-person testing and evaluation, thus making this model of care difficult to access and time consuming for many patients. The emergence of portable instruments for measuring anticoagulant effect in capillary whole blood made it possible for patients receiving warfarin to self-monitor the effect of their anticoagulant therapy. Self-monitoring empowers patients, offers the advantage of more frequent monitoring, and increases patient convenience by allowing testing at home and avoiding the need for frequent laboratory and clinic visits. Self-monitoring can entail patient self-testing (PST) and/or patient self-management (PSM). Several studies have evaluated and shown the benefit of both PST and PSM models of care when compared with either routine medical care or anticoagulation clinic management of anticoagulation therapy. Self-monitoring (PSM and/or PST) of anticoagulation results in lower thromboembolic events, lower mortality, and no increase in major bleeding when compared with standard care. Despite favorable results and enhanced patient convenience, the adoption of self-monitoring into clinical practice in the United States has been limited, especially in higher risk, disadvantaged populations. Although the emergence of a multitude of novel oral anticoagulants will permit clinicians to better individualize anticoagulant therapy options by choosing the optimum regimen based on individual patient characteristics, it is also expected that traditional agents will continue to play a role in a significant subset of patients. For those patients treated with traditional anticoagulants such as warfarin, future models of care will entail patient-centered management such as PST and PSM. The incorporation of technology (i.e., Web-based expert systems) is expected to further improve the outcomes realized by PST and PSM. Further studies are needed to explore factors that influence the adoption of self-monitoring in the United States and to evaluate the feasibility and implementation in real-life clinical settings.

show abstract

Comparison of INR stability between self-monitoring and standard laboratory method: Preliminary results of a prospective study in 67 mechanical heart valve patients

Cited by 28 publications

References 24 publications

Results of mechanical versus tissue AVR: caution in young patients with tissue AVR

Results of mechanical versus tissue AVR: caution in young patients with tissue AVR

Introduction of Centralized Inr Control in Kuzbass

Anticoagulation Patient Self‐Monitoring in the United States: Considerations for Clinical Practice Adoption

Contact Info

Product

Resources

About