Key result
Remote INR monitoring achieves similar TTR to traditional laboratory control.
Why the study?
Systems for INR self-determination may improve monitoring adherence in patients on vitamin K antagonists, but real-world evidence in Russia is limited.
Does remote self-monitoring of INR using the CoaguChek INRange system improve time in therapeutic range compared to conventional laboratory control in patients receiving warfarin after mechanical heart valve implantation?
Cohort (n=101)
No
Does remote self-monitoring of INR using the CoaguChek INRange system improve time in therapeutic range compared to conventional laboratory control in patients receiving warfarin after mechanical heart valve implantation?
Absolute Event Rate: 67.7% vs 66.7%
p-value: p=0.55
Remote self-monitoring of INR is as effective as conventional outpatient laboratory monitoring for maintaining time in therapeutic range in patients with mechanical heart valves on warfarin.
Remote INR monitoring yields comparable TTR in mechanical valve patients on warfarin; leaves open need for randomized confirmation before practice change.
Background. Systems for self-determination of international normalized ratio (INR) may increase adherence to regular monitoring of hemostasis parameters in patients taking vitamin K antagonists. However, evidence of the effectiveness of self-determination of INR in real-world clinical practice in Russia is limited. Aim. To compare the effectiveness of remote monitoring of INR using the CoaguChek® INRange coagulometer in patients who have undergone mechanical heart valve implantation with traditional INR control by measuring it in the outpatient department laboratory. Materials and methods. A prospective study enrolled 101 patients receiving warfarin after a mitral or aortic mechanical heart valve prosthesis implantation. In Group 1 (n=51), conventional laboratory INR control was used; in Group 2 (n=50), patients monitored INR by themselves using a CoaguChek® INRange coagulometer. The follow-up duration was 1 year. Results. Patients in Groups 1 and 2 did not differ in INR: 2.62 [2.45; 2.85] vs 2.6 [2.5; 2.8], respectively (data are presented as the median [1st to 3rd quartile]), and the time of INR in the therapeutic range: 66.7% [50; 78.6] vs 67.7% [53.2; 80.6]. The intervals between INR determinations in Group 1 were significantly longer: 30.5 [29.5; 31] days vs 20 [13; 25] days. Conclusion. The CoaguChek® INRange system enables remote patient monitoring during continuous warfarin therapy and achievement of the target INR with a time in the therapeutic range comparable to that for patients with INR measurements in outpatient laboratories.
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Проваторов et al. (2024) conducted a cohort in Mechanical heart valve prosthesis requiring warfarin therapy (n=101). Remote monitoring of INR using CoaguChek INRange vs. Traditional laboratory INR control was evaluated on Time in therapeutic range (TTR) (p=0.55). Remote monitoring of INR using the CoaguChek INRange system achieved a time in therapeutic range of 67.7%, comparable to the 66.7% achieved with traditional laboratory control (p=0.55).
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