Telemedicine-guided, very low-dose international normalized ratio self-control in patients with mechanical heart valve implants

Abstract

Telemedicine-guided very low-dose INR self-control is comparable with low-dose INR in thrombotic risk, and is superior in bleeding risk. Weekly testing is sufficient. Given the small number of MVR and DVR patients, results are only valid for AVR patients.

2017 ESC/EACTS Guidelines for the Management of Valvular Heart Disease

“…171 Recent randomized trials supported lower target INRs for aortic prostheses. [186][187][188] However, limited statistical power, certain methodological concerns and the restriction to certain prostheses and/or to the use of INR selfmanagement led the Task Force not to change recommendations for target INR. We recommend a median INR value rather than a range to avoid considering extreme values in the target range as a valid target INR. High variability of the INR is a strong independent predictor of reduced survival after valve replacement.…”

Guía ESC/EACTS 2017 sobre el tratamiento de las valvulopatías

“…Algunos estudios aleatorizados recientes respaldan el uso de objetivos de INR más bajos en el caso de las prótesis aórticas [186][187][188] . Sin embargo, debido a su escasa potencia estadística, algunos problemas metodológicos y la restricción a ciertas prótesis o el control del INR por el propio paciente, este Grupo de Trabajo no ha cambiado las recomendaciones sobre el objetivo de INR.…”

Predictors of anticoagulation quality in 15 834 patients performing patient self‐management of oral anticoagulation with vitamin K antagonists in real‐life practice: a survey of the International Self‐Monitoring Association of Orally Anticoagulated Patients

“…The final model for predicting poor anticoagulation control included intensity of target range, interval of measurements, type of management and sex, with an area under the ROC curve of 0Á65 (95% CI 0Á64, 0Á66; see Fig 2). Several sensitivity analyses were conducted: (i) using (Koertke et al, 2007(Koertke et al, , 2015. Several sensitivity analyses were conducted: (i) using (Koertke et al, 2007(Koertke et al, , 2015.…”