Point-of-Care Testing in Hypercoagulable Conditions Managed With Warfarin

A Review

Abstract

Purpose 

The aim of this review was to summarize new data on the use of international normalized ratio (INR) point-of-care testing (POCT) devices in hypercoagulable disease states such as antiphospholipid syndrome (APS) and those with left ventricular assist devices (LVADs).

Methods 

PubMed and Google Scholar were searched for keywords relating to warfarin, point-of-care testing, and hypercoagulable conditions. Intensive care unit studies and articles not in English were excluded.

Results 

Four recent studies examining 3 different POCT devices in patients with APS and 2 for patients with LVADs were found. The studies compared devices against laboratory INRs as a standard or against another POCT device to determine device agreeability or bias. Results showed that CoaguChek XS does not correlate well with laboratory INRs in patients with APS but is acceptable in LVAD patients. Coagsense and ProTime InRhythm correlated well with laboratory INR values in APS patients.

Conclusions 

Coagsense and ProTime InRhythm may be acceptable POCT devices to use for APS patients, whereas CoaguChek XS is not acceptable. In LVAD patients, CoaguChek XS is acceptable because it correlates well with laboratory INR values.