1. IN ANTICOAGULATION TREATMENT WITH VITAMIN K ANTAGONISTS (AVKS): WHICH IS THE BEST
MONITORING TEST?
Autores / Authors
Alicia Beatriz Vilaseca* 1, Gustavo L. Vidmar1, Claudio C. D´Antonio1, Cecilia L. Capmany1, Jimena M. Bonadeo1, Nadia I. Kujta1, Ruben F. Barbera2, Elizabeth L. Velasquez3, Lorena A. Meza3.
Clínica San Camilo Buenos Aires Argentina (1,3Hematology -2 Internal Medicine)
Filiación / Hospital
OBJECTIVES
METHODS
In order to demonstrate that we can improve the monitoring of INR with the use of Technology Point of Care (POC), we compared two anticoagulated patient populations .This two populations received attention in the same Anticoagulation Clinic, with the same Medical Staff, taking decisions. One population in POC monitoring and the other in Traditional Monitoring (TM), randomized according to the
methodology paid by their Medical Insurance .
Retrospective analysis of 103 patients INR tested with POC technology (Coaguchek XSPro –Roche
Diagnostics), and 103 patients with traditional test TCOAG TriniCLOT PT HTF human thromboplastine (ISI near 1.1)
and Automated Autoanalyzer (Tcoag) Destiny Plus, from January 2014 to December 2014.(Laboratory participant of Randox Qualyti Control,”RIQAS”).
Percentage of visit in Range (Traditional INR %) and Time in Therapeutic Range (TTR)(Rosendaal Method for % INR in range - method which INR-specific person-time is calculated by incorporating the frequency of INR measurements and their actual values, and assuming that changes between consecutive INR measurements are linear over time) were calculated.
RESULTS
TM population (TMP) shows: TTR : 55,45% versus POC population(POCP) TTR:62,57% (TMP: Total average days in range 156,02, Total average days of follow up 281,32; POCP 185,06; ( Total average days in range Total average days of follow up 295,78) (p 0,006) and TMP % visit in range 52,85% versus POCP 62,07% visit in range (p 0,001).
REFERENCES
1-Murray ET1, Fitzmaurice DA, McCahon D. Point of care testing for INR monitoring: where are we now? Br J Haematol. 2004 Nov;127(4):373-8.
2- Ryan F1, O'Shea S, Byrne S. The reliability of point-of-care prothrombin time testing. A comparison of CoaguChek S and XS INR measurements with hospital laboratory monitoring. Int J Lab Hematol. 2010 Feb;32
3- Barcellona D, Fenu L, Cornacchini S, Marongiu F. Telemedicine can improve the quality of oral anticoagulation using portable devices and self-testing at home. J Telemed Telecare.2013 Sep;19(6):
4- Dusse LM, Oliveira NC, Rios DR, Marcolino MS. Point-of-care test (POCT) INR: hope or illusion? Rev Bras Cir Cardiovasc.2012 Apr-Jun;27(2):
CONCLUSIONS
Probably POC technology (reducing preanalytic and analytic variables) could be an alternative to improve
INR test quality, making safer and comfortable traditional treatment with vitamin K antagonist. We think ,that monitoring with POC it’s a valid alternative for improve TTR in all circumstances where NOACs can´t be used.