Of all the disease states requiring anticoagulation monitoring, atrial fibrillation (AF) may represent the greatest challenge to healthcare providers.
Of all the disease states requiring anticoagulation monitoring, atrial fibrillation (AF) may represent the greatest challenge to healthcare providers. The condition is already the most widespread type of sustained cardiac arrhythmia and continues to increase in both prevalence and clinical complexity. Fortunately, new monitoring technology—such as the CoaguChek XS System from Roche Diagnostics—is now available to help healthcare professionals bring the benefits of point-of-care (POC) prothrombin time (PT)/international normalized ratio (INR) testing to more patients with AF and others on anticoagulation therapy, along with faster treatment decisions and the potential to help prevent strokes and other adverse events.
Atrial Fibrillation Treatment
It is currently estimated that 2.3 million adults in the US have AF, and some estimates suggest that—based on the aging US population—this number will increase to 3.3 million by 2020 and 5.6 million by 2050. The disease carries serious implications, including the potential for stroke. In fact, about 15% of strokes occur in people with atrial fibrillation. Therefore, stroke prevention is imperative with these patients. The clinical guidelines for stroke prevention in at-risk patients include anticoagulation (bloodthinning) therapy with warfarin sodium. To ensure proper dosing of warfarin, clinicians must monitor the therapeutic effects of the anticoagulant, as each patient reacts differently. Therefore, clinicians test patients regularly to determine and regulate their PT, normally indicated in international normalized ratio (INR) units.
Conventionally, anticoagulation patients have gone to a laboratory or to their physician’s office to get a venous blood sample drawn for a PT/INR test to be done at a later time. It can take several hours or even days to obtain the results, which may potentially delay the therapeutic decision to adjust a patient’s dosage. This approach to anticoagulation therapy may increase the risk of adverse effects—such as thrombosis or bleeding—and may limit the healthcare provider’s treatment options for addressing them in the hospital should the patient have to be admitted for a thromboembolic or bleeding complication.
However, technology has been available since 1994 that enables healthcare professionals to easily monitor their patients’ PT/INR at the point of care. By providing immediate access to anticoagulation results, this technology allows caregivers to make on-the-spot therapy decisions and adjust medication dosages to help protect patients from complications. The caregiver can also explain the changes, make sure the patient understands them, and counsel the patient on diet or other lifestyle changes that can impact the anticoagulation therapy, all in one office visit.
Those benefi ts can now be extended to a broader range of anticoagulation patients, thanks to a new generation of anticoagulation monitoring technology. The CoaguChek XS System, recently FDA-cleared for office use and patient self-testing, provides on-the-spot information about the patient’s PT/INR level. This system offers “smart” technology that healthcare professionals can use to manage in-office PT/INR testing more effectively. The CoaguChek XS System is the only anticoagulation monitoring system to perform onboard quality control and determine patients’ results in a single test chamber, feature designed to save time and provide enhanced confidence in the quality of results. The system provides accurate, precise results in just one minute from a small (10μL) drop of blood obtained from a fingerstick with one device.