Comparison of the international normalized ratio levels obtained by portable coagulometer and laboratory in a clinic specializing in oral anticoagulation

Meneghelo, Zilda; Barroso, Cecília Maria Quaglio; Liporace, Idelzuíta Leandro; Corá, Aline Pivetta

doi:10.1111/ijlh.12333

Cited by 16 publications

(9 citation statements)

References 13 publications

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“…In our study, the correlation was also very strong when the CoaguChek XS Plus was compared with the photo‐optical (Sysmex CS‐2100i/CA‐1500) and the mechanical clot detection methods (Thrombolyzer XRC). Previous studies, that compared the CoaguChek XS Plus with photo‐optical (Sysmex analysers) or mechanical clot detection methods (STAGO analysers), found correlation coefficients approximately 0.95‐0.96; however, the CoaguChek XS Plus had never been compared before with different laboratory techniques simultaneously.…”

Section: Discussionmentioning

confidence: 99%

A comparative study using thrombin generation and three different INR methods in patients on Vitamin K antagonist treatment

Riva

Vella

Meli

et al. 2017

Int J Lab Hematology

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Summary Introduction Vitamin K antagonist (VKA) treatment requires routine monitoring using the international normalized ratio (INR). However, different INR assays may vary in their results. The aim of this study was to assess the agreement of three different INR methods, compared with thrombin generation, in patients on VKA treatment. Methods Sixty patients attending the Anticoagulation Clinic at Mater Dei Hospital (Msida, Malta) for VKA monitoring between August and September 2015 were enrolled. The INR was tested using a point‐of‐care (POC) device (CoaguChek XS Plus, Roche Diagnostics) for both capillary and venous blood samples, a photo‐optical (Sysmex CS‐2100i/CA‐1500, Siemens) and a mechanical clot detection system (Thrombolyzer XRC, Behnk Elektronik). All assays used human recombinant thromboplastin as reagent. Thrombin generation was performed using the calibrated automated thrombogram. Results There was a negative curvilinear correlation between the endogenous thrombin potential and different INR assays (r≤−.75) and a strong positive linear correlation between the CoaguChek XS Plus on capillary samples and the other INR methodologies (r≥.96). Conclusion All different INR assays showed good correlation with the thrombin generation potential. The POC INR showed one of the highest correlation coefficients with thrombin generation, confirming the POC devices as an accurate, valid alternative to laboratory INR in VKA patients.

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Section: Discussionmentioning

confidence: 99%

A comparative study using thrombin generation and three different INR methods in patients on Vitamin K antagonist treatment

Riva

Vella

Meli

et al. 2017

Int J Lab Hematology

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“…Using whole blood assays is advantageous, as it reduces the sample preparation thus increasing the throughput. Typical test times for these commercial devices is approximately 2-10 min [65,66].…”

Section: Electrical Impedance Dependent Detection Techniquesmentioning

confidence: 99%

Microfluidics in Haemostasis: A Review

et al. 2020

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Haemostatic disorders are both complex and costly in relation to both their treatment and subsequent management. As leading causes of mortality worldwide, there is an ever-increasing drive to improve the diagnosis and prevention of haemostatic disorders. The field of microfluidic and Lab on a Chip (LOC) technologies is rapidly advancing and the important role of miniaturised diagnostics is becoming more evident in the healthcare system, with particular importance in near patient testing (NPT) and point of care (POC) settings. Microfluidic technologies present innovative solutions to diagnostic and clinical challenges which have the knock-on effect of improving health care and quality of life. In this review, both advanced microfluidic devices (R&D) and commercially available devices for the diagnosis and monitoring of haemostasis-related disorders and antithrombotic therapies, respectively, are discussed. Innovative design specifications, fabrication techniques, and modes of detection in addition to the materials used in developing micro-channels are reviewed in the context of application to the field of haemostasis.

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“…The standard plasma-based PT-INR is not a point-of-care method. However, there are several point-of-care whole blood PT methods [22], and some of these can monitor both high and low PTs in warfarin-treated patients [23].…”

Section: Rotem Extem and Ptmentioning

confidence: 99%

Journal of Cardiovascular Medicine and Cardiology

Schött¹

2019

Int J Vasc Surg Med

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Background: Warfarin-treated patients with a prolonged Prothrombin Time (PT) can have a normal rotational thromboelastometry (ROTEM) clotting time (CT). A previous in vitro study found that activated prothrombin complex concentrates (APCC) could reverse an albumin-induced coagulopathy monitored with ROTEM, but that prothrombin complex concentrates (PCC) could not. The aim of this study was to investigate the ability of ROTEM to monitor the in vitro reversal of warfarin-induced coagulopathy using APCC and to defi ne an APCC dose response. Method: During the routine control of PT in 27 patients treated with warfarin, one extra 4.5 ml test tube of citrated whole blood was retrieved. Two concentrations of tissue factor ROTEM tissue factor (TF) activating reagents were used: a standard ROTEM ExTEM and a diluted 1:19000 concentration. The effects of two separate doses of APCC added in vitro corresponding to in vivo doses of 50 IE or 100 IE/kg were then studied on the ROTEM. Results: The ROTEM EXTEM CT was prolonged beyond the upper normal range of 68 s in patients with PT >3.0, with a correlation coeffi cient of 0.88 to PT. ROTEM with the ExTEM reagent alongside high and low doses of APCC resulted in a signifi cant shortening of median CT, both compared to baseline (100 s) and after low (65 s) and high doses (57 s). This was most evident in patients with PT >2.0. ROTEM signals of clot propagation to clot formation time (CFT) and α angle had the reverse pattern. There was no effect on maximal clot strength with APCC. With the diluted TF no CT shortening was found with APCC. Conclusion: A clear dose response of APCC added in vitro to correct the effects of warfarin on ROTEM EXTEM CT was verifi ed. ROTEM CT should be tested with non-activated PCC for in vivo reversal of warfarin in patients along with verifi cation of a normalised PT. Further studies are needed to verify if a ROTEM CT in the lower normal range of <57-65 s, as found in our in vitro APCC-spiked warfarin blood, is safe for invasive procedures.

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Comparison of the international normalized ratio levels obtained by portable coagulometer and laboratory in a clinic specializing in oral anticoagulation

Cited by 16 publications

References 13 publications

A comparative study using thrombin generation and three different INR methods in patients on Vitamin K antagonist treatment

A comparative study using thrombin generation and three different INR methods in patients on Vitamin K antagonist treatment

Microfluidics in Haemostasis: A Review

Journal of Cardiovascular Medicine and Cardiology

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