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

Detalhes bibliográficos
Autor(a) principal: Bruch,Tatiana P.
Data de Publicação: 2014
Outros Autores: Mendes,Danielle C., Pedrozo,Jeff C., Figueiredo,Lívia, Nóvak,Edison M., Zétola,Viviane F., Lange,Marcos C.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Arquivos de neuro-psiquiatria (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2014000700487
Resumo: 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.
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spelling Is point-of-care accurate for indicating thrombolysis in anticoagulated patients on oral anticoagulation treatments?ischemic strokethrombolytic therapywarfarincontraindicationsanticoagulationThe 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. Academia Brasileira de Neurologia - ABNEURO2014-07-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2014000700487Arquivos de Neuro-Psiquiatria v.72 n.7 2014reponame:Arquivos de neuro-psiquiatria (Online)instname:Academia Brasileira de Neurologiainstacron:ABNEURO10.1590/0004-282X20140075info:eu-repo/semantics/openAccessBruch,Tatiana P.Mendes,Danielle C.Pedrozo,Jeff C.Figueiredo,LíviaNóvak,Edison M.Zétola,Viviane F.Lange,Marcos C.eng2014-07-14T00:00:00Zoai:scielo:S0004-282X2014000700487Revistahttp://www.scielo.br/anphttps://old.scielo.br/oai/scielo-oai.php||revista.arquivos@abneuro.org1678-42270004-282Xopendoar:2014-07-14T00:00Arquivos de neuro-psiquiatria (Online) - Academia Brasileira de Neurologiafalse
dc.title.none.fl_str_mv Is point-of-care accurate for indicating thrombolysis in anticoagulated patients on oral anticoagulation treatments?
title Is point-of-care accurate for indicating thrombolysis in anticoagulated patients on oral anticoagulation treatments?
spellingShingle Is point-of-care accurate for indicating thrombolysis in anticoagulated patients on oral anticoagulation treatments?
Bruch,Tatiana P.
ischemic stroke
thrombolytic therapy
warfarin
contraindications
anticoagulation
title_short Is point-of-care accurate for indicating thrombolysis in anticoagulated patients on oral anticoagulation treatments?
title_full Is point-of-care accurate for indicating thrombolysis in anticoagulated patients on oral anticoagulation treatments?
title_fullStr Is point-of-care accurate for indicating thrombolysis in anticoagulated patients on oral anticoagulation treatments?
title_full_unstemmed Is point-of-care accurate for indicating thrombolysis in anticoagulated patients on oral anticoagulation treatments?
title_sort Is point-of-care accurate for indicating thrombolysis in anticoagulated patients on oral anticoagulation treatments?
author Bruch,Tatiana P.
author_facet Bruch,Tatiana P.
Mendes,Danielle C.
Pedrozo,Jeff C.
Figueiredo,Lívia
Nóvak,Edison M.
Zétola,Viviane F.
Lange,Marcos C.
author_role author
author2 Mendes,Danielle C.
Pedrozo,Jeff C.
Figueiredo,Lívia
Nóvak,Edison M.
Zétola,Viviane F.
Lange,Marcos C.
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Bruch,Tatiana P.
Mendes,Danielle C.
Pedrozo,Jeff C.
Figueiredo,Lívia
Nóvak,Edison M.
Zétola,Viviane F.
Lange,Marcos C.
dc.subject.por.fl_str_mv ischemic stroke
thrombolytic therapy
warfarin
contraindications
anticoagulation
topic ischemic stroke
thrombolytic therapy
warfarin
contraindications
anticoagulation
description 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.
publishDate 2014
dc.date.none.fl_str_mv 2014-07-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2014000700487
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2014000700487
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/0004-282X20140075
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Academia Brasileira de Neurologia - ABNEURO
publisher.none.fl_str_mv Academia Brasileira de Neurologia - ABNEURO
dc.source.none.fl_str_mv Arquivos de Neuro-Psiquiatria v.72 n.7 2014
reponame:Arquivos de neuro-psiquiatria (Online)
instname:Academia Brasileira de Neurologia
instacron:ABNEURO
instname_str Academia Brasileira de Neurologia
instacron_str ABNEURO
institution ABNEURO
reponame_str Arquivos de neuro-psiquiatria (Online)
collection Arquivos de neuro-psiquiatria (Online)
repository.name.fl_str_mv Arquivos de neuro-psiquiatria (Online) - Academia Brasileira de Neurologia
repository.mail.fl_str_mv ||revista.arquivos@abneuro.org
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