ArticleResearch and practice in thrombosis and haemostasis2020
Is the time in therapeutic range on coumarins predicted by previous time in therapeutic range?
Article in Research and practice in thrombosis and haemostasis, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Is the time in therapeutic range on coumarins predicted by previous time in therapeutic range?Research and practice in thrombosis and haemostasis · 2020Article
- Effect of switching from acenocoumarol to phenprocoumon on time in therapeutic range and INR variability: A cohort study.PloS one · 2020Article
- The quality of pharmacist-led community warfarin management across 2 provinces in Canada: A cross-sectional observational study.Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPCArticle
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe benefit of vitamin K antagonists depends on the time within the therapeutic range (TTR). A patient's previous TTR could be a factor in the decision to change the anticoagulation regimen. However, the predictive value of a previous TTR for a future TTR is not well established, nor is it clear which TTR should prompt action.
objectivesTo investigate the predictive performance of a TTR and identify a threshold below which no recovery of TTR should be expected. PATIENTS/
methodsFrom 18 031 patients who used acenocoumarol in a first-line anticoagulation clinic, a TTR was calculated over multiple periods of 90, 180, and 365 days each. We assessed the correlation between baseline and later TTR and the separation between groups by quintile of baseline TTR. We describe the proportion of patients who obtain a TTR≥ 70% conditional on baseline TTR.
resultsThe correlation between baseline and later TTR was 0.25 (95% confidence interval [CI], 0.24-0.26), 0.27 (95% CI, 0.26-0.28) and 0.34 (95% CI, 0.32-0.35) for analyses over 90, 180, and 365 days. Corresponding c statistics for discrimination by baseline group were 0.60, 0.61, and 0.63. The probability to obtain a TTR ≥70% increased with baseline TTR: from 42% with a baseline TTR of 50%-65% when TTR was 100% (TTR calculated over 180 days).
conclusionsWe conclude that a current TTR hardly predicts a future TTR. Physicians and patients should deliberate together which probabilities to accept, take measures to improve TTR, and consider potential alternatives.
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