Safety and efficacy of using portable coagulation monitor for INR examination after left-sided mechanical prosthetic valve replacement
Abstract Background Time in therapeutic range (TTR) is an index to assess the effectiveness of anticoagulation and is important to predict the risk of bleeding and thrombosis in patients taking warfarin. In recent years, the portable coagulation monitor, a point-of-care testing device for patients t...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-022-02046-8 |
| _version_ | 1811302312039153664 |
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| author | Yue Shen Fu-xiu Zhong Xue-shan Huang |
| author_facet | Yue Shen Fu-xiu Zhong Xue-shan Huang |
| author_sort | Yue Shen |
| collection | DOAJ |
| description | Abstract Background Time in therapeutic range (TTR) is an index to assess the effectiveness of anticoagulation and is important to predict the risk of bleeding and thrombosis in patients taking warfarin. In recent years, the portable coagulation monitor, a point-of-care testing device for patients to perform self-management international normalized ratio (INR) examination, has provided an opportunity to improve the quality of oral warfarin treatment. In this study, we applied TTR to evaluate the safety and efficacy of the portable coagulation monitor for patients with oral anticoagulant warfarin after left-sided mechanical prosthetic valve (MPV) replacement. Methods It is a single-centre cohort study. From September 2019 to June 2021, a total of 243 patients who returned to our institution for outpatient clinic revisit at 3 months after left-sided MPV replacement, met the inclusion criteria and agreed to be followed up were included. Self-management group used portable coagulation monitor for INR examination, and patients in the conventional group had their INR monitored in routine outpatient visits. Clinical data of the patients would be recorded for the next 12 months, and results were compared between the two groups to assess the effect of the coagulation monitor on TTR and complications related to bleeding and thrombosis in patients with left-sided MPV replacement. Results A total of 212 individuals provided complete and validated INR data spanning of 1 year. Those who applied the portable coagulation monitor had higher TTR values and larger number of tests for INR. No significant differences were seen between the two groups in postoperative bleeding and thromboembolic complications, but portable coagulation monitor showed a trend toward fewer bleeding events. Conclusion Portable devices for coagulation monitoring are safe and can achieve a higher TTR. Patients who use the portable coagulation monitor for home INR self-management can achieve a safe and effective warfarin therapy. |
| first_indexed | 2024-04-13T07:27:08Z |
| format | Article |
| id | doaj.art-8a9ce15e0ecc47a8a9ff66b2e3b48d86 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-13T07:27:08Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-8a9ce15e0ecc47a8a9ff66b2e3b48d862022-12-22T02:56:28ZengBMCJournal of Cardiothoracic Surgery1749-80902022-12-011711610.1186/s13019-022-02046-8Safety and efficacy of using portable coagulation monitor for INR examination after left-sided mechanical prosthetic valve replacementYue Shen0Fu-xiu Zhong1Xue-shan Huang2Department of Cardiovascular Surgery, Union Hospital, Fujian Medical UniversityFujian Key Laboratory of Cardio-thoracic Surgery, Fujian Medical UniversityDepartment of Cardiovascular Surgery, Union Hospital, Fujian Medical UniversityAbstract Background Time in therapeutic range (TTR) is an index to assess the effectiveness of anticoagulation and is important to predict the risk of bleeding and thrombosis in patients taking warfarin. In recent years, the portable coagulation monitor, a point-of-care testing device for patients to perform self-management international normalized ratio (INR) examination, has provided an opportunity to improve the quality of oral warfarin treatment. In this study, we applied TTR to evaluate the safety and efficacy of the portable coagulation monitor for patients with oral anticoagulant warfarin after left-sided mechanical prosthetic valve (MPV) replacement. Methods It is a single-centre cohort study. From September 2019 to June 2021, a total of 243 patients who returned to our institution for outpatient clinic revisit at 3 months after left-sided MPV replacement, met the inclusion criteria and agreed to be followed up were included. Self-management group used portable coagulation monitor for INR examination, and patients in the conventional group had their INR monitored in routine outpatient visits. Clinical data of the patients would be recorded for the next 12 months, and results were compared between the two groups to assess the effect of the coagulation monitor on TTR and complications related to bleeding and thrombosis in patients with left-sided MPV replacement. Results A total of 212 individuals provided complete and validated INR data spanning of 1 year. Those who applied the portable coagulation monitor had higher TTR values and larger number of tests for INR. No significant differences were seen between the two groups in postoperative bleeding and thromboembolic complications, but portable coagulation monitor showed a trend toward fewer bleeding events. Conclusion Portable devices for coagulation monitoring are safe and can achieve a higher TTR. Patients who use the portable coagulation monitor for home INR self-management can achieve a safe and effective warfarin therapy.https://doi.org/10.1186/s13019-022-02046-8Coagulation monitorWarfarin therapyMechanical prosthetic valve |
| spellingShingle | Yue Shen Fu-xiu Zhong Xue-shan Huang Safety and efficacy of using portable coagulation monitor for INR examination after left-sided mechanical prosthetic valve replacement Journal of Cardiothoracic Surgery Coagulation monitor Warfarin therapy Mechanical prosthetic valve |
| title | Safety and efficacy of using portable coagulation monitor for INR examination after left-sided mechanical prosthetic valve replacement |
| title_full | Safety and efficacy of using portable coagulation monitor for INR examination after left-sided mechanical prosthetic valve replacement |
| title_fullStr | Safety and efficacy of using portable coagulation monitor for INR examination after left-sided mechanical prosthetic valve replacement |
| title_full_unstemmed | Safety and efficacy of using portable coagulation monitor for INR examination after left-sided mechanical prosthetic valve replacement |
| title_short | Safety and efficacy of using portable coagulation monitor for INR examination after left-sided mechanical prosthetic valve replacement |
| title_sort | safety and efficacy of using portable coagulation monitor for inr examination after left sided mechanical prosthetic valve replacement |
| topic | Coagulation monitor Warfarin therapy Mechanical prosthetic valve |
| url | https://doi.org/10.1186/s13019-022-02046-8 |
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