The Point-of-Care INR Test for Vitamin K Antagonist Monitoring

Anderson, Irsk; Wool, Geoffrey D.; Madden, William G.

doi:10.1001/jama.2019.15720

Cited by 6 publications

(5 citation statements)

References 6 publications

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“…Our finding is in line with previous studies that showed a positive bias of POC INR values and the bigger systemic difference in higher INR values 10‐14 . The US Food and Drug Administration (FDA) recommends that a POC INR value >4.5 should be confirmed by laboratory analyzers, 32 and Anderson, et al 33 suggested an even lower INR cutoff of 3.5 for patients' safety. Our results cannot be extrapolated to other and newer reagents.…”

Section: Discussionsupporting

confidence: 92%

Performance evaluation of coaguchek pro II in comparison with coaguchek XS plus and sta‐r Max using a sta‐neoplastine CI plus

Nam

Hur

Kim

et al. 2021

Int J Lab Hematology

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Introduction We evaluated the analytical performance of CoaguChek Pro II (Roche Diagnostics GmbH, Mannheim, Germany), a new point‐of‐care device measuring the international normalized ratio (INR) values, in comparison with CoaguChek XS Plus (Roche Diagnostics GmbH) and STA‐R Max using STA‐Neoplastine CI Plus (Diagnostica Stago SAS, Asnières‐sur‐Seine, France). Methods The precision of Pro II was analyzed, according to the Clinical and Laboratory Standards Institute guidelines (CLSI POCT14‐A2 and EP15‐A3). In 105 clinical samples, the Pro II INR values were compared with those of XS Plus and STA‐R Max using STA‐Neoplastine CI Plus (CLSI EP09‐A3 and EP35). We also compared the Pro II INR values between capillary blood (CB) and venous blood (VB; CLSI EP35). Results The precision of Pro II was acceptable (within‐run and between‐run CV%: 2.71% and 3.28% at normal level; 1.52% and 4.47% at abnormal level, respectively). The Pro II INR values showed very high correlation and almost perfect agreement with those of XS Plus and STA‐R Max using STA‐Neoplastine CI Plus (r = .97 and κ = .94; r = .95 and κ = .91). The mean difference between Pro II and STA‐R Max using STA‐Neoplastine CI Plus increased as INR values increased, with 60% of samples showing differences >0.5 in the supratherapeutic range. The Pro II INR values showed very high correlation between CB and VB (r = .98). Conclusion Pro II INR values are accurate and reliable using both CB and VB; however, they should be confirmed by laboratory analyzers in the supratherapeutic range.

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Section: Discussionsupporting

confidence: 92%

Performance evaluation of coaguchek pro II in comparison with coaguchek XS plus and sta‐r Max using a sta‐neoplastine CI plus

Nam

Hur

Kim

et al. 2021

Int J Lab Hematology

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“…These devices are commonly utilized in outpatient ambulatory care settings to provide therapeutic drug monitoring for patients on warfarin therapy. 8 There are also a subset of patients who may be qualified to monitor their INR from home with their own POC INR machine. The results of the HOME INR Study (THINRS) showed that patients monitoring their INR from home utilizing POC INR machines significantly increased patient satisfaction and quality of life.…”

Section: Purposementioning

confidence: 99%

Evaluating the Effect of Timing on Point-of-Care Testing of INR

Son

Kim²

2023

Journal of Pharmacy Practice

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Objectives To evaluate if there is a difference in International Normalized Ratio (INR) readings taken within the 15 second time frame after lancing the finger vs 30-60 seconds of obtaining a blood drop utilizing a CoaguChek® XS Plus point-of-care (POC) INR machine in patients on warfarin therapy. Methods All adult patients on anticoagulation therapy with warfarin who were managed in a pharmacist-run anticoagulation clinic were considered for inclusion in the study. The mean difference of INR readings taken less than 15 seconds vs between 30-60 seconds after the blood drop was obtained from the finger was assessed. Results A total of 62 pairs of INR results were included in the study. There was a mean difference in INR of .076 (95% CI 0.011-.140; P = .0217) when comparing INR readings taken less than 15 seconds and between 30-60 seconds after the blood drop was obtained from the finger. Conclusions There was a significant difference in INR readings taken less than 15 seconds vs 30-60 seconds after obtaining the blood drop when utilizing a POC INR machine. INR readings taken 30-60 seconds after obtaining a blood drop with the CoaguChek® XS Plus POC INR machine is not acceptable for use to monitor patients on warfarin.

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“…International Normalised Ratio (INR) is a laboratory test used to check the anticoagulant effect of warfarin by using the outcome of the prothrombin time (PT) test, a measurement which monitors the time it takes blood to coagulate (Anderson, Wool and Madden, 2019). Target INR for those prescribed anticoagulants is ideally 2.5 (therapeutic range between 2-3), or 3.5 for individuals with recurrent VTE's (Keeling et al, 2011;Pavord and Webster, 2015;AAGBI, 2016;NICE, 2020).…”

Section: International Normalised Ratio (Inr)mentioning

confidence: 99%

Care of the surgical patient—part 2: oral anticoagulants

Ford

Robertson

2020

Br J Nurs

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Part two of this series on the care of the surgical patient introduces readers to some of the additional risks associated with patients who are undergoing surgery and taking oral anticoagulants. It explores the use of vitamin K antagonists and heparin. Some of the management strategies and additional considerations that need to be addressed during the perioperative care continuum will also be discussed.

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The Point-of-Care INR Test for Vitamin K Antagonist Monitoring

Cited by 6 publications

References 6 publications

Performance evaluation of coaguchek pro II in comparison with coaguchek XS plus and sta‐r Max using a sta‐neoplastine CI plus

Performance evaluation of coaguchek pro II in comparison with coaguchek XS plus and sta‐r Max using a sta‐neoplastine CI plus

Evaluating the Effect of Timing on Point-of-Care Testing of INR

Care of the surgical patient—part 2: oral anticoagulants

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