• Mayo Clinic proceedings · Apr 2024

    CoaguChek and Coag-Sense PT2 Meter Point of Care INR Device Validation.

    • Robert D McBane, Carlee O'Connor, Jennifer Lutz, Jennifer Blanco, Levi A Hartman, Anna Kramer, Josephine Uy, Traci Schumann, Katherine Hartung, Michael Luker, David Hodge, Paula Santrach, and Brad S Karon.
    • Gonda Vascular Center, Mayo Clinic, Rochester, MN, USA; Cardiovascular Department, Mayo Clinic, Rochester, MN, USA. Electronic address: mcbane.robert@mayo.edu.
    • Mayo Clin. Proc. 2024 Apr 24.

    ObjectiveTo standardize international normalized ratio (INR) measurements and improve data integrity by enabling electronic result transmission for warfarin monitoring, two point-of-care (POC) devices were evaluated against an internal plasma INR reference method.MethodsA multicenter study was pursued (January 24, 2022, through October 19, 2022) to compare concordance of two commercially available POC devices, Coag-Sense PT2 Meter (Coag-Sense) and CoaguChek XS Pro and Plus devices (CoaguChek), against an internal plasma INR method among patients treated with warfarin. Bias and linear regression analysis were assessed for these devices including dosing decision accuracy compared with plasma INR reference.ResultsTwo hundred ninety-nine patients treated with warfarin across three Mayo Clinic sites agreed to participate. Atrial fibrillation (n=191, 63.9%), venous thromboembolism (n=65; 21.7%), and heart valve prosthesis (n=46; 15.4%) were common anticoagulant indications with a 2.5 INR target for 280 (93.6%) of patients. For the CoaguChek devices, 243 (81.3%) of values fell within 0.2 INR units with plasma INR referent and 285 (95.3%) within 0.4 units (R2=0.93). For the Coag-Sense device, 102 (34.1%) of values fell within 0.2 INR units and 180 (60.2%) within 0.4 INR units of plasma INR values, (R2=0.83; P<.0001). Using the plasma INR as the gold standard, appropriate dosing recommendations would have occurred for 292 (97.7%) of the CoaguChek and 244 (81.6%) of the Coag-Sense results.ConclusionCompared with a plasma referent, INR values obtained from the CoaguChek devices exhibited less systematic bias compared with Coag-Sense measures. This translates to a greater percentage of concordant management decisions between POC and laboratory INR methods.Copyright © 2023 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

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