Prognostic Value of Prothrombin Time International Normalized Ratio in Acute Decompensated Heart Failure　– A Combined Marker of Hepatic Insufficiency and Hemostatic Abnormality –

Okada, Atsushi; Sugano, Yasuo; Nagai, Toshiyuki; Takashio, Seiji; Honda, Satoshi; Asaumi, Yasuhide; Aiba, Takeshi; Noguchi, Teruo; Kusano, Kengo; Ogawa, Hisao; Yasuda, Satoshi; Anzai, Toshihisa

doi:10.1253/circj.cj-15-1326

Cited by 41 publications

(27 citation statements)

References 70 publications

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“…The prognostic role of PT has been evaluated in several clinical settings, being identified as a predictor of death after myocardial infarction [110,111], after surgical intervention [112], in acute decompensated heart failure [113] or in neoplastic diseases [114]. PT is commonly used to evaluate the extrinsic and common pathways of coagulation, thus detecting low fibrinogen concentrations and deficiencies of factors II, V, VII, and X [115].…”

Section: Discussionmentioning

confidence: 99%

Hemostatic Changes in Patients with COVID-19: A Meta-Analysis with Meta-Regressions

Minno

Calcaterra

Lupoli

et al. 2020

JCM

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Background: Complications of coronavirus disease 2019 (COVID-19) include coagulopathy. We performed a meta-analysis on the association of COVID-19 severity with changes in hemostatic parameters. Methods: Data on prothrombin time (PT), activated partial thromboplastin time (aPTT), D-Dimer, platelets (PLT), or fibrinogen in severe versus mild COVID-19 patients, and/or in non-survivors to COVID-19 versus survivors were systematically searched. The standardized mean difference (SMD) was calculated. Results: Sixty studies comparing 5487 subjects with severe and 9670 subjects with mild COVID-19 documented higher PT (SMD: 0.41; 95%CI: 0.21, 0.60), D-Dimer (SMD: 0.67; 95%CI: 0.52, 0.82), and fibrinogen values (SMD: 1.84; 95%CI: 1.21, 2.47), with lower PLT count (SMD: −0.74; 95%CI: −1.01, −0.47) among severe patients. Twenty-five studies on 1511 COVID-19 non-survivors and 6287 survivors showed higher PT (SMD: 0.67; 95%CI: 0.39, 0.96) and D-Dimer values (SMD: 3.88; 95%CI: 2.70, 5.07), with lower PLT count (SMD: −0.60, 95%CI: −0.82, −0.38) among non-survivors. Regression models showed that C-reactive protein values were directly correlated with the difference in PT and fibrinogen. Conclusions: Significant hemostatic changes are associated with COVID-19 severity. Considering the risk of fatal complications with residual chronic disability and poor long-term outcomes, further studies should investigate the prognostic role of hemostatic parameters in COVID-19 patients.

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Section: Discussionmentioning

confidence: 99%

Hemostatic Changes in Patients with COVID-19: A Meta-Analysis with Meta-Regressions

Minno

Calcaterra

Lupoli

et al. 2020

JCM

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“…Okada et al. showed that increased INR was associated with future adverse events in acute, decompensated heart failure. Our findings are in agreement with the above‐mentioned studies’ results, in which prolonged PT and increased INR were associated with mortality.…”

Section: Discussionmentioning

confidence: 99%

The relation between international normalized ratio and mortality in acute pulmonary embolism: A retrospective study

Kırış

Yazıcı

Durmuş

et al. 2017

Clinical Laboratory Analysis

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“…It was noticed that compared with median INR, the high INR was significantly associated with the high risk of 1-year stroke outcomes including all-cause mortality, stroke recurrence, combined end point, and poor functional outcome. In previously published studies, the association between elevated baseline INR and poor outcomes in patients with acute decompensated heart failure and acute pulmonary embolism was investigated 10, 11) . A plausible explanation for this phenomenon might be that after an ischemic event, the activation of the coagulation system may result in the consumption of coagulation factors, which is manifested as an elevated INR.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of International Normalized Ratio in Ischemic Stroke Patients without Atrial Fibrillation or Anticoagulation Therapy

Xie

Wang

et al. 2019

JAT

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Aim: The impact of international normalized ratio (INR) on prognosis after acute ischemic stroke without anticoagulation therapy is unclear. Herein, the association between baseline INR and stroke outcomes in patients without anticoagulation therapy was investigated. Methods: A total of 14,782 ischemic stroke patients from the China National Stroke Registry II were included in this analysis. The period of follow-up was 1 year after stroke onset. Multivariate logistic regression models were used to estimate the relationship between INR and stroke outcomes including all-cause death, recurrent stroke, composite end point, and poor functional outcome. Results: Of 14,782 patients with stroke, all-cause death occurred in 1080 (7.3%), recurrence stroke in 538 (3.9%), combined end point in 1319 (8.9%), and poor functional outcome in 3001 (20.3%). Compared with the medium INR group (0.9–1.1), the odds ratios with confidence intervals of 95% for the high INR group (> 1.1) were 1.58 (1.32–1.98) for all-cause death, 1.40 (1.10–1.79) for stroke recurrence, 1.52 (1.29–1.79) for combined end point, and 1.21 (1.06–1.39) for poor functional outcome. No association between low INR (< 0.9) and any stroke outcomes was found compared with the medium group. Conclusions: Increased admission INR was associated with adverse stroke outcomes among acute ischemic stroke patients without atrial fibrillation or anticoagulation therapy.

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Prognostic Value of Prothrombin Time International Normalized Ratio in Acute Decompensated Heart Failure　– A Combined Marker of Hepatic Insufficiency and Hemostatic Abnormality –

Cited by 41 publications

References 70 publications

Hemostatic Changes in Patients with COVID-19: A Meta-Analysis with Meta-Regressions

Hemostatic Changes in Patients with COVID-19: A Meta-Analysis with Meta-Regressions

The relation between international normalized ratio and mortality in acute pulmonary embolism: A retrospective study

Prognostic Value of International Normalized Ratio in Ischemic Stroke Patients without Atrial Fibrillation or Anticoagulation Therapy

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Prognostic Value of Prothrombin Time International Normalized Ratio in Acute Decompensated Heart Failure – A Combined Marker of Hepatic Insufficiency and Hemostatic Abnormality –

Cited by 41 publications

References 70 publications

Hemostatic Changes in Patients with COVID-19: A Meta-Analysis with Meta-Regressions

Hemostatic Changes in Patients with COVID-19: A Meta-Analysis with Meta-Regressions

The relation between international normalized ratio and mortality in acute pulmonary embolism: A retrospective study

Prognostic Value of International Normalized Ratio in Ischemic Stroke Patients without Atrial Fibrillation or Anticoagulation Therapy

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Prognostic Value of Prothrombin Time International Normalized Ratio in Acute Decompensated Heart Failure　– A Combined Marker of Hepatic Insufficiency and Hemostatic Abnormality –