Control of anticoagulation with vitamin K antagonists: overestimation of median time in therapeutic range when assessed by linear interpolation
| Autor: | Henk J. Adriaansen, A. M. H. P. Van Den Besselaar, Felix J. M. van der Meer, Frank W.G. Leebeek, Joseph S. Biedermann, Marieke J. H. A. Kruip |
|---|---|
| Přispěvatelé: | Hematology |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
endocrine system
medicine.medical_specialty Vitamin K Wilcoxon signed-rank test Correlation coefficient medicine.drug_class Urology 030204 cardiovascular system & hematology Vitamin k Linear interpolation Phenprocoumon 03 medical and health sciences therapeutic control 0302 clinical medicine Therapeutic index Medicine Humans 030212 general & internal medicine International Normalized Ratio Netherlands Acenocoumarol business.industry fungi Anticoagulants Hematology Vitamin K antagonist Models Theoretical Surgery time in therapeutic range business medicine.drug |
| Zdroj: | Thrombosis and Haemostasis, 116(4), 679-686 Thrombosis and Haemostasis, 116(4), 679-686. Georg Thieme Verlag |
| ISSN: | 0340-6245 |
| Popis: | SummaryPatients receiving vitamin K–antagonists are monitored by regular assessment of the International Normalized Ratio (INR). There are two popular methods for therapeutic control of anticoagulation in patient groups: 1) Time in Therapeutic Range (TTR) assessed by linear interpolation of successive INR measurements; 2) the cross-sectional proportion (CSP) of all patients’ last INRs within range. The purpose of the present study is to compare the two methods using data from 53 Dutch Thrombosis Centres and to develop a semi-quantitative model for TTR based on different types of INR change. Different groups of around 400,000 patients in four consecutive years were evaluated: patients in the induction phase, short-term, long-term, low-target range, high-target range, receiving either acenocoumarol or phenprocoumon, and performing self-management. Each Centre provided TTR and CSP results for each patient group. TTR and CSP were compared using the Wilcoxon signed-rank test. Separately, we analysed the relationship between consecutive INR results regarding in or out of range and their frequency of occurrence in patients of two different cohorts. Good correlation was observed between TTR and CSP (correlation coefficient 0.694–0.950 in low-target range). In long-term acenocoumarol patients (low-target range) the median TTR was significantly higher than CSP (80.0 % and 78.7 %, respectively; p |
| Databáze: | OpenAIRE |
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