Use of the Chromogenic Factor X Assay to Predict the International Normalized Ratio in Patients Transitioning from Argatroban to Warfarin
| Autor: | Paul A. Arpino, Elizabeth M. Van Cott, Zareh Demirjian |
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| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty Urology Arginine Argatroban Hospitals University chemistry.chemical_compound Predictive Value of Tests medicine Coagulation testing Humans Pharmacology (medical) International Normalized Ratio Prospective Studies Blood Coagulation Aged Sulfonamides Receiver operating characteristic Chromogenic business.industry Factor X Warfarin Anticoagulants Middle Aged Chromogenic Compounds Confidence interval ROC Curve chemistry Pipecolic Acids Anesthesia Female business medicine.drug |
| Zdroj: | Pharmacotherapy. 25:157-164 |
| ISSN: | 0277-0008 |
| DOI: | 10.1592/phco.25.2.157.56950 |
| Popis: | Study Objective. To determine the clinical utility of the chromogenic factor X level for conversion from argatroban to warfarin in hospitalized patients. Design. Prospective observational study. Patients. Sixty-two hospitalized patients with indications for anticoagulation in whom the chromogenic factor X assay was used for conversion from argatroban to warfarin. Setting. University-affiliated hospital. Intervention. From December 2003–May 2004, data for all patients in whom the chromogenic factor X assay was used for conversion from argatroban to warfarin were screened for inclusion. When the chromogenic factor X level was satisfactory, the clinician discontinued the argatroban and a confirmatory international normalized ratio (INR) was obtained. Measurements and Main Results. To determine the ability of the chromogenic factor X level to predict the INR free of argatroban influence, we calculated the sensitivity and specificity by using a cutoff chromogenic factor X level of 45% or less, or greater than 45%, which corresponded to an INR of 2 or greater, or less than 2, respectively. We constructed a receiver operating characteristic curve to illustrate various cutoff levels of chromogenic factor X. Of 146 patients screened, 62 had data that met criteria for analysis. An average of 6 ± 3 doses of warfarin were administered before the confirmatory coagulation studies were obtained. The average time from the chromogenic factor X measurement to obtainment of confirmatory coagulation studies was 9 ± 4 hours. Use of a chromogenic factor X level of 45% or less to predict an INR of 2 or greater absent of argatroban influence had a sensitivity of 93%, a specificity of 78%, and an accuracy of 89%. The area under the receiver operating characteristic curve was 0.91 (95% confidence interval 0.81–0.99, p |
| Databáze: | OpenAIRE |
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