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Security and cost comparison of INR self-testing and conventional hospital INR testing in patients with mechanical heart valve replacement.

Chen QL, Dong L, Dong YJ, Zhao SL, Fu B, Wang YQ, Jiang H - J Cardiothorac Surg (2015)

Bottom Line: No significant difference of the INR results were observed between group 1 and group 2, they showed significant relevance, r = 0.953(p < 0.05).Self-testing of anticoagulation therapy reduced the cost and the time required for re-examination.Results of CoaguChek XS monitor are precise and have a good consistency and stability as compared with traditional laboratory testing.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P R China. scchenqiulin@163.com.

ABSTRACT

Background: International normalized ratio (INR) self-testing can improve the management of anticoagulation therapy with warfarin for the patients following mechanical heart valve replacement. Several reviews and studies have demonstrated self-management as an option to improve patient's outcome considerably after mechanical heart valve replacement. We sought to analyze the security, economy and discuss the prospect of self-testing of anticoagulation therapy in patients following mechanical heart valve replacement in China, and evaluate the accuracy and stability of CoaguChek XS portable INR-testing device.

Methods: This was a prospective self-controlled clinical study conducted with 526 patients receiving oral warfarin anticoagulation therapy after mechanical heart valve replacement in the period of Mar.1, 2012 - Nov.1, 2012 in Cardiovascular Surgery Department of West China Hospital of Sichuan University. The same patient performed INR testing with CoaguChek XS portable coagulometer (group1) and central lab (group 2) in parallel. The follow-up time was 6 months. Meanwhile, a questionnaire was handed out to survey the expenses required for the re-examination visits to the hospital, time, and anticoagulation complications.

Results: No severe anticoagulation complications occurred in all the patients. No significant difference of the INR results were observed between group 1 and group 2, they showed significant relevance, r = 0.953(p < 0.05). Compared with the conventional method of INR testing in hospital, the portable coagulometer is convenient, quick and less traumatic. Self-testing of anticoagulation therapy reduced the cost and the time required for re-examination.

Conclusions: Results of CoaguChek XS monitor are precise and have a good consistency and stability as compared with traditional laboratory testing. For the patients receiving anticoagulation therapy after mechanical heart valve replacement, the self-testing of anticoagulation therapy with portable coagulometer is a safe choice, and it has a promising future application in China.

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Diagram of bias of the INR values from lab testing and from CoaguChek XS testing.
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Fig2: Diagram of bias of the INR values from lab testing and from CoaguChek XS testing.

Mentions: Five hundred and twenty six patients were tested for 2079 times in total with CoaguChek XS portable coagulometer and traditional central lab automatic coagulometer in parallel. The results of linear regression analysis on the two groups of data are shown as the Figure 1. It is shown that the regression equation for measured value of CoaguChek XS portable coagulometer (y axis) and lab measured value (x axis) is y = 0.155 + 0.911x. Good correlation between the INR measured values of the two groups can be observed (r = 0.953, p < 0.05). Meanwhile, its bias can be observed with Bland-Altman diagram, as shown in Figure 2, the gap between the measured value from CoaguChek XS portable coagulometer and the measured value from traditional central lab is −0.033 ± 0.15732, proving good consistency between the two groups.Figure 1


Security and cost comparison of INR self-testing and conventional hospital INR testing in patients with mechanical heart valve replacement.

Chen QL, Dong L, Dong YJ, Zhao SL, Fu B, Wang YQ, Jiang H - J Cardiothorac Surg (2015)

Diagram of bias of the INR values from lab testing and from CoaguChek XS testing.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4308889&req=5

Fig2: Diagram of bias of the INR values from lab testing and from CoaguChek XS testing.
Mentions: Five hundred and twenty six patients were tested for 2079 times in total with CoaguChek XS portable coagulometer and traditional central lab automatic coagulometer in parallel. The results of linear regression analysis on the two groups of data are shown as the Figure 1. It is shown that the regression equation for measured value of CoaguChek XS portable coagulometer (y axis) and lab measured value (x axis) is y = 0.155 + 0.911x. Good correlation between the INR measured values of the two groups can be observed (r = 0.953, p < 0.05). Meanwhile, its bias can be observed with Bland-Altman diagram, as shown in Figure 2, the gap between the measured value from CoaguChek XS portable coagulometer and the measured value from traditional central lab is −0.033 ± 0.15732, proving good consistency between the two groups.Figure 1

Bottom Line: No significant difference of the INR results were observed between group 1 and group 2, they showed significant relevance, r = 0.953(p < 0.05).Self-testing of anticoagulation therapy reduced the cost and the time required for re-examination.Results of CoaguChek XS monitor are precise and have a good consistency and stability as compared with traditional laboratory testing.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P R China. scchenqiulin@163.com.

ABSTRACT

Background: International normalized ratio (INR) self-testing can improve the management of anticoagulation therapy with warfarin for the patients following mechanical heart valve replacement. Several reviews and studies have demonstrated self-management as an option to improve patient's outcome considerably after mechanical heart valve replacement. We sought to analyze the security, economy and discuss the prospect of self-testing of anticoagulation therapy in patients following mechanical heart valve replacement in China, and evaluate the accuracy and stability of CoaguChek XS portable INR-testing device.

Methods: This was a prospective self-controlled clinical study conducted with 526 patients receiving oral warfarin anticoagulation therapy after mechanical heart valve replacement in the period of Mar.1, 2012 - Nov.1, 2012 in Cardiovascular Surgery Department of West China Hospital of Sichuan University. The same patient performed INR testing with CoaguChek XS portable coagulometer (group1) and central lab (group 2) in parallel. The follow-up time was 6 months. Meanwhile, a questionnaire was handed out to survey the expenses required for the re-examination visits to the hospital, time, and anticoagulation complications.

Results: No severe anticoagulation complications occurred in all the patients. No significant difference of the INR results were observed between group 1 and group 2, they showed significant relevance, r = 0.953(p < 0.05). Compared with the conventional method of INR testing in hospital, the portable coagulometer is convenient, quick and less traumatic. Self-testing of anticoagulation therapy reduced the cost and the time required for re-examination.

Conclusions: Results of CoaguChek XS monitor are precise and have a good consistency and stability as compared with traditional laboratory testing. For the patients receiving anticoagulation therapy after mechanical heart valve replacement, the self-testing of anticoagulation therapy with portable coagulometer is a safe choice, and it has a promising future application in China.

Show MeSH