title: Is point-of-care accurate for indicating thrombolysis in anticoagulated patients on oral anticoagulation treatments?
abstract: The use of oral anticoagulation treatment (OAT) in patients with an international normalized ratio (INR) higher than 1.7 is a contraindication to thrombolysis in acute ischemic stroke. The aim of the present study is to compare the use of point-of-care (POC) coagulometers to the standard coagulation analysis (SCA) procedure of the INR as a decision-making test for use with patients taking OAT.
  
  
  METHODS
  Eighty patients on chronic OAT underwent a POC and an SCA during a regular outpatient evaluation.
  
  
  RESULTS
  When comparing the abilities of the POC test and the SCA test to identify adequate levels for thrombolysis (≤1.7), the POC had a sensitivity of 96.6% (95%CI 88.4-99.1) and a specificity of 60.0% (95%CI 38.6-78). POC overestimated INR levels by 0.51 points compared to the SCA test.
  
  
  CONCLUSIONS
  POC has a high sensitivity compared to the SCA test for the identification of patients within the cut-off point for thrombolysis.
authors: Divisão de Neurologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors: Tatiana P
authors: TP
authors: Bruch
authors: Divisão de Neurologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors: Danielle C
authors: DC
authors: Mendes
authors: Divisão de Neurologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors: Jeff C
authors: JC
authors: Pedrozo
authors: Divisão de Neurologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors: Lívia
authors: L
authors: Figueiredo
authors: Divisão de Neurologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors: Edison M
authors: EM
authors: Nóvak
authors: Divisão de Neurologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors: Viviane F
authors: VF
authors: Zétola
authors: Divisão de Neurologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors: Marcos C
authors: MC
authors: Lange
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000188:drug therapy; D000075202:Contraindications; D005260:Female; D006801:Humans; D019934:International Normalized Ratio / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems / Q000592:standards*; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D020521:Stroke / Q000188:drug therapy; D015912:Thrombolytic Therapy
chemical_list: D000925:Anticoagulants