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Revista chilena de cardiología

versão On-line ISSN 0718-8560

Resumo

NIETO, Elena et al. Types of Thromplastin used for INR determination in patients under chronic oral anticoagulant treatment. Rev Chil Cardiol [online]. 2015, vol.34, n.2, pp.134-139. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602015000200008.

Background: INR (International Normalized Ratio) is the standard Prothrombin Time parameter for monitoring anticoagulant treatment with coumarin derivatives Recommendations of WHO indicate that precision in the calculation of the INR can be improved using thromboplastins with a low Index of International Sensibility (ISI=1,0). Discrepancies in INR obtained using either this technique or conventional rabbit brain derived reagents in the same sample in patients attending the Servicio de Salud Metropolitano Occidente (West Metropolitan Health Service) were observed. Our objective was to evaluate these discrepancies in a systematic way. Materials and methods: A comparative study was conducted using two thromboplastins of different ISI (1.0 and 1.3) for the calculation of venous INR in comparison with capillary INR in 100 patients.  Results: The study showed that INR values may differ significantly according to the method used. In particular, rabbit brain thromboplastin ISI = 1.3 underestimates the value of INR in the range of INR ≥3.0.  Conclusions: The use of human recombinant thromboplastin ISI= 1.0. for determination of INR may significantly decrease the risk of hemorrhagic complications in patients requiring higher levels of anticoagulation.

Palavras-chave : thromboplastin; ISI; INR; oral anticoagulants; Acenocoumarol.

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