Comparison of international normalized ratio audit parameters in patients enrolled in GARFIELD-AF and treated with vitamin K antagonists.

Autor: Fitzmaurice DA; Primary Care Clinical Sciences, School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK., Accetta G; Thrombosis Research Institute, London, UK., Haas S; Formerly Technical University of Munich, Munich, Germany., Kayani G; Thrombosis Research Institute, London, UK., Lucas Luciardi H; School of Medicine, National University of Tucumán, San Miguel de Tucumán, Argentina., Misselwitz F; Global Clinical Development, Bayer HealthCare Pharmaceuticals, Berlin, Germany., Pieper K; Duke Clinical Research Institute, Durham, NC, USA., Ten Cate H; Laboratory for Clinical Thrombosis and Hemostasis, Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands., Turpie AG; Department of Medicine, McMaster University Hamilton, Canada., Kakkar AK; Thrombosis Research Institute, London, UK.; Department of Surgery, University College London, London, UK.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2016 Aug; Vol. 174 (4), pp. 610-23. Date of Electronic Publication: 2016 Apr 12.
DOI: 10.1111/bjh.14084
Abstrakt: Vitamin K antagonist (VKA) therapy for stroke prevention in atrial fibrillation (AF) requires monitoring of the international normalized ratio (INR). We evaluated the agreement between two INR audit parameters, frequency in range (FIR) and proportion of time in the therapeutic range (TTR), using data from a global population of patients with newly diagnosed non-valvular AF, the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF). Among 17 168 patients with 1-year follow-up data available at the time of the analysis, 8445 received VKA therapy (±antiplatelet therapy) at enrolment, and of these patients, 5066 with ≥3 INR readings and for whom both FIR and TTR could be calculated were included in the analysis. In total, 70 905 INRs were analysed. At the patient level, TTR showed higher values than FIR (mean, 56·0% vs 49·8%; median, 59·7% vs 50·0%). Although patient-level FIR and TTR values were highly correlated (Pearson correlation coefficient [95% confidence interval; CI], 0·860 [0·852-0·867]), estimates from individuals showed widespread disagreement and variability (Lin's concordance coefficient [95% CI], 0·829 [0·821-0·837]). The difference between FIR and TTR explained 17·4% of the total variability of measurements. These results suggest that FIR and TTR are not equivalent and cannot be used interchangeably.
(© 2016 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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