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


Fitzmaurice D. A., Accetta G., Haas S., Kayani G., Lucas Luciardi H., Misselwitz F., ...Daha Fazla

BRITISH JOURNAL OF HAEMATOLOGY, cilt.174, sa.4, ss.610-623, 2016 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 174 Sayı: 4
  • Basım Tarihi: 2016
  • Doi Numarası: 10.1111/bjh.14084
  • Dergi Adı: BRITISH JOURNAL OF HAEMATOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.610-623
  • Anahtar Kelimeler: atrial fibrillation, frequency in range, international normalized ratio, time in therapeutic range, vitamin K antagonists, CONCORDANCE CORRELATION-COEFFICIENT, ATRIAL-FIBRILLATION, ANTICOAGULATION CONTROL, ANTITHROMBOTIC THERAPY, ORAL ANTICOAGULANT, MANAGEMENT, INTENSITY, QUALITY, TIME, COUNTRIES
  • Gazi Üniversitesi Adresli: Evet

Özet

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.