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SHR Neuro Cancer Cardio Lipid Metab Microb

Schettle, S; Schlöglhofer, T; Zimpfer, D; Schima, H; Kaufmann, F; Salimbangon, A; Wolforth, J; Schroeder, S; Hards, R; Ritchie, B; Staley, L; Pereira, N; Kushwaha, S; Maltais, S; Stulak, J.
International Analysis of LVAD Point-of-Care Versus Plasma INR: A Multicenter Study.
ASAIO J. 2018; 64(6):e161-e165 Doi: 10.1097/MAT.0000000000000845
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Co-authors Med Uni Graz: Zimpfer Daniel
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Abstract:: International normalized ratio (INR) measurements manage risks of bleeding and clotting sequelae in the population with left ventricular assist device (LVAD). Studies suggest that point-of-care (POC) INR does not significantly differ from plasma INR (P-INR) values in other patient populations, although this has not been validated in a multicenter LVAD study. We sought to determine whether POC-INR and P-INR values differ significantly in the LVAD population and reviewed patients with permanent LVAD implantation at seven institutions internationally. Our cohort comprised of 279 paired POC-INR and P-INR checks in patients supported on average 630 ± 598 days postimplant with predominately HeartWare, HeartMate II, and HeartMate III devices. The population averaged 57.9 years of age, and there were 86.7% male. We found no statistically significant difference between POC-INR and P-INR values. International normalized ratio accuracy correlated weakly with the time between INR measurements (p < 0.001). When the time difference was less than 4 hours, the difference between INR pairs was significantly lower than measurements greater than 8 hours (p = 0.006). There was no statistically significant difference when comparing paired INR values and time after implant to INR check (p = 0.43), age (p = 0.12), known coagulopathy (p = 0.12), bleeding history (p = 0.22), or thrombosis history (p = 0.34). This is the first large multicenter international study comparing POC-INR and P-INR measurements in patients with LVAD and found no statistically significant difference between either methods, particularly when measured within less than 4 hours of each other.
Find related publications in this database (using NLM MeSH Indexing): Aged - administration & dosage; Cohort Studies - administration & dosage; Female - administration & dosage; Heart-Assist Devices - adverse effects; Humans - administration & dosage; International Normalized Ratio - methods; Male - administration & dosage; Middle Aged - administration & dosage; Point-of-Care Systems - administration & dosage; Thrombosis - prevention & control
Find related publications in this database (Keywords): LVAD; home INR; LVAD warfarin; LVAD anticoagulation; LVAD point of care INR