Is point-of-care accurate for indicating thrombolysis in anticoagulated patients on oral anticoagulation treatments?

Arquivos de Neuro-Psiquiatria

Tatiana P. Bruch¹  Danielle C. Mendes¹  Jeff C. Pedrozo¹  Lívia Figueiredo¹  Edison M. Nóvak¹  Viviane F. Zétola¹  Marcos C. Lange¹ 

关键词: ischemic stroke;    thrombolytic therapy;    warfarin;    contraindications;    anticoagulation;    acidente vascular cerebral;    terapia trombolítica;    testes de coagulação sanguínea;    varfarina;    antagonistas da vitamina K;    anticoagulação oral;   

DOI  :  10.1590/0004-282X20140075

来源: SciELO

【 摘 要 】

The use of oral anticoagulation treatment (OAT) in patients with an international normalized ratio (INR) higher than 1.7 is a contraindication to thrombolysis in acute ischemic stroke. The aim of the present study is to compare the use of point-of-care (POC) coagulometers to the standard coagulation analysis (SCA) procedure of the INR as a decision-making test for use with patients taking OAT.Method:Eighty patients on chronic OAT underwent a POC and an SCA during a regular outpatient evaluation. Results:When comparing the abilities of the POC test and the SCA test to identify adequate levels for thrombolysis (≤1.7), the POC had a sensitivity of 96.6% (95%CI 88.4-99.1) and a specificity of 60.0% (95%CI 38.6-78). POC overestimated INR levels by 0.51 points compared to the SCA test. Conclusion:POC has a high sensitivity compared to the SCA test for the identification of patients within the cut-off point for thrombolysis.

【 授权许可】

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