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Thromb Res. 2010 Feb;125(2):192-5. doi: 10.1016/j.thromres.2009.09.004. Epub 2009 Nov 25.
Point of care (POC) devices measuring the international normalized ratio (INR) are accurate for patients with stable disease, but their efficiency has not been prospectively assessed during the "bridging period" when patients are receiving a low molecular weight heparin (LMWH) on top of a vitamin K antagonist (VKA) until the target INR is reached.
188 dual INR measurement using the POC (INR(POC)) and the laboratory (INR(lab)) at the same time were consecutively determined : 69 in patients receiving LMWH+VKA (bridging group) and 119 in patients receiving only a VKA (control group). INRpoc was compared to INR(lab).
Test strip failure rate was higher in the bridging group than in the control group (29% vs 4%; p<0,001). In successful tests, POC accuracy was not modified by LMWH administration: the correlation coefficients between POC and lab INR values for the bridging group and the control group were 0,81 and 0,87 respectively, and the relative measure of divergence (RMD=INR(lab) - INR(poc)/INR(lab)) was lower in the bridging group than in the control group (4+/-7% vs 10+/-14%; p=0,02). Finally, clinically relevant agreement between POC and laboratory was of 90% in the bridging group and 92.1% in the control group (p=0.6).
With the POC used (INRatio), in patients receiving LMWH when the POC gives a result, it is as accurate as in patients not receiving a LMWH.
即时检测（POC）设备在测量国际标准化比值（INR）时，对于病情稳定的患者是准确的，但它们在“桥接期”的效率尚未得到前瞻性评估，在此期间，患者在接受维生素 K 拮抗剂（VKA）的同时还接受低分子肝素（LMWH），直到达到目标 INR 为止。
连续对 188 例同时进行 POC（INR(POC)) 和实验室（INR(lab)) 双重 INR 测量：69 例接受 LMWH+VKA 的患者（桥接组）和 119 例仅接受 VKA 的患者（对照组）。比较 INRpoc 与 INR(lab)。
桥接组的检测条失败率高于对照组（29%比 4%；p<0.001）。在成功的测试中，LMWH 的给药并未改变 POC 的准确性：桥接组和对照组 POC 和实验室 INR 值之间的相关系数分别为 0.81 和 0.87，桥接组的相对偏差（RMD=INR(lab) - INR(poc)/INR(lab)）低于对照组（4+/-7%比 10+/-14%；p=0.02）。最后，桥接组 POC 和实验室之间的临床相关一致性为 90%，对照组为 92.1%（p=0.6）。
在接受 LMWH 的患者中，当 POC 给出结果时，其与未接受 LMWH 的患者一样准确。
