Key result
TEG and RapidTEG show unacceptably low ~55% sensitivity for detecting warfarin-induced coagulopathy.
Why the study?
TEG and RapidTEG results are commonly normal in patients receiving warfarin despite increased INR, raising concerns about their sensitivity to warfarin coagulopathy.
Are TEG and RapidTEG reliable for detecting warfarin-induced coagulopathy compared to INR in patients undergoing elective cardioversion?
Population
22 consecutive patients undergoing elective cardioversion and receiving warfarin
Comparison
TEG and RapidTEG testing vs INR and Prothrombin Time
Design
Prospective cohort study
Authors
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TEG and RapidTEG should not supplant INR for warfarin assessment before cardioversion; Level 3 data leaves open need for prospective validation.
Cohort (n=22)
No
Are TEG and RapidTEG reliable for detecting warfarin-induced coagulopathy compared to INR in patients undergoing elective cardioversion?
TEG and RapidTEG are insensitive and unreliable for detecting warfarin-induced coagulopathy, frequently yielding normal results despite elevated INRs.
Dunham et al. (2014) conducted a cohort in Warfarin-coagulopathy (n=22). Warfarin therapy vs. Normal reference range was evaluated on Sensitivity of TEG R-Time for detecting warfarin coagulopathy (INR > 1.5) (95% CI 34.5-73.1). TEG and RapidTEG demonstrated unacceptably low sensitivities of 54.5% and 59.1%, respectively, for detecting warfarin-induced coagulopathy in patients with an elevated INR.
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