Arquivos de Neuro-Psiquiatria ()

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

  • Tatiana P. Bruch,
  • Danielle C. Mendes,
  • Jeff C. Pedrozo,
  • Lívia Figueiredo,
  • Edison M. Nóvak,
  • Viviane F. Zétola,
  • Marcos C. Lange

DOI
https://doi.org/10.1590/0004-282X20140075
Journal volume & issue
Vol. 72, no. 7
pp. 487 – 489

Abstract

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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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