Key result
Point-of-care INR testing using CoaguChek was a median of 63 minutes faster than central laboratory testing, providing a rapid means to acquire INR in acute clinical situations.
Why the study?
Does point-of-care INR testing provide comparable and faster results compared to central laboratory testing in patients with acute stroke symptoms?
Observational (n=529)
No
Does point-of-care INR testing provide comparable and faster results compared to central laboratory testing in patients with acute stroke symptoms?
Effect estimate: median 63 minutes faster
Point-of-care INR testing is a safe and significantly faster method to acquire INR values in acute stroke patients compared to central laboratory testing.
May facilitate timely decisions in acute anticoagulation; leaves open effects on clinical outcomes.
OBJECTIVES: Effective anticoagulant therapy is a contraindication to thrombolysis, which is an effective treatment of ischemic stroke if given within 4.5 hours of symptom onset. INR above 1.7 is generally considered a contraindication for thrombolysis. Rapid measurement of INR in warfarin-treated patients is therefore of major importance in order to be able to decide on thrombolysis or not. We asked whether INR measured on a point-of-care instrument would be as good as a central laboratory instrument. MATERIAL AND METHODS: A total of 529 consecutive patients who arrived at the emergency department at a large urban teaching hospital with stroke symptoms were enrolled in the study. INR was measured with a CoaguChek and a Sysmex instrument. Basic clinical information such as age, sex, and diagnosis (if available) was recorded. INR from the instruments was compared using linear regression and Bland-Altman plot. RESULTS: = 0.97). In the current setting, CoaguChek was in median 63 minutes faster than Sysmex. CONCLUSION: Our results indicate that point-of-care testing is a safe mean to rapidly acquire a patient's INR value in acute clinical situations.
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Zenlander et al. (2017) conducted an observational in Acute stroke (n=529). Point-of-care INR testing (CoaguChek) vs. Central laboratory INR testing (Sysmex) was evaluated on Time to INR result (median 63 minutes faster). Point-of-care INR testing using CoaguChek was a median of 63 minutes faster than central laboratory testing, providing a rapid means to acquire INR in acute clinical situations.
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