Background: Commonly the frequency of international normalized ratio (INR) monitoring with a conventional laboratory test in stable patients is once a month. When using a dedicated personal device for INR assessment, the frequency may be increased to two or more times a month.
Objective: To show that INR assessed by self-measurement at home is reliable and feasible in the mid-term and improves medical care.
Patients And Methods: All patients in the study on INR self-measurement (clinical trial.gov: NCT00925197), conducted between 2004 and 2007, were re-contacted for mid-term follow-up. One hundred and seventy eight out of 192 patients who participated in the study answered a questionnaire. The average follow-up time was 4.2 years (±1) for the self-measurement group and 4.9 years (±1) for the laboratory-analyzed control group.
Results: Only 26 patients (group A) continued to use INR self-measurement to monitor treatment with vitamin K antagonists (VKA). The main reasons to stop INR self-measurement were its high cost and difficulty in obtaining strips. There were significantly fewer bleeding complications (p=0.04) and complications related to VKA (p=0.01) in self-measured patients compared to the control group. Feelings of security and quality of life were also significantly better (p=0.002) for self-measured patients.
Conclusion: Many patients with a mechanical heart valve, who self-measured INR, continue to use this method for their follow-up because of its positive effects on their health and quality of life.
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http://dx.doi.org/10.1016/j.thromres.2013.09.013 | DOI Listing |
J Cardiol Cases
October 2020
Department of Cardiovascular Medicine, Saga University, Saga, Japan.
Device infection and stroke are still frequently reported as complications of left ventricular assist devices, and strict management of anticoagulation therapy is sometimes difficult at the time of infection status. We report the case of a 55-year-old man with a HeartMate II (Abbott, Inc., Abbott Park, IL, USA) as a bridge to cardiac transplantation.
View Article and Find Full Text PDFA woman in her seventies who was started on warfarin after heart valve replacement began outpatient adjuvant chemotherapy with tegafur-uracil/leucovorin for rectal cancer. The patient performed weekly INR self-measurements at a health insurance pharmacy between outpatient visits. Results recorded in her personal medicine notebook were shared between her physician, a hospital pharmacist, and a pharmacy pharmacist.
View Article and Find Full Text PDFAdv Ther
June 2014
De Nationale Trombose Dienst (The National Thrombosis Service), Zonneoordlaan 17, 6718 TK, Ede, The Netherlands,
Introduction: Long-term anticoagulation therapy using vitamin K antagonists (VKA) is used in millions of patients worldwide to reduce the risk of thrombotic or thromboembolic events. Control and monitoring of VKA therapy is improved by the regular self-measurement of international normalized ratio (INR) using a home monitoring device. This retrospective analysis of a large cohort of patients in the Netherlands seeks to determine whether the choice of INR monitor could have a clinical impact on patient outcomes.
View Article and Find Full Text PDFThromb Haemost
May 2014
Prof. Jean-Yves Le Heuzey, Cardiology and Arrhythmology, Georges Pompidou Hospital, René Descartes University, 20, rue Leblanc, 75908 Paris Cedex, France, Tel. : +33 1 5609 37 01, E-mail:
Due to improved implementation of guidelines, new scoring approaches to improve risk categorisation, and introduction of novel oral anticoagulants, medical management of patients with atrial fibrillation (AF) is continuously improving. The PREFER in AF registry enrolled 7,243 consecutive patients with ECG-confirmed AF in seven European countries in 2012-2013 (mean age: 71.5 ± 10.
View Article and Find Full Text PDFThromb Res
February 2014
Heart surgery Department, G. Montpied Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand, France.
Background: Commonly the frequency of international normalized ratio (INR) monitoring with a conventional laboratory test in stable patients is once a month. When using a dedicated personal device for INR assessment, the frequency may be increased to two or more times a month.
Objective: To show that INR assessed by self-measurement at home is reliable and feasible in the mid-term and improves medical care.
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