Real-world effectiveness of remote monitoring of the international normalized ratio in patients undergoing heart valve replacement using the CoaguChek® INRange system with a remote data transmission module

Background. Systems for self-determination of international normalized ratio (INR) may increase adherence to regular monitoring of hemostasis parameters in patients taking vitamin K antagonists. However, evidence of the effectiveness of self-determination of INR in real-world clinical practice in Russia is limited. Aim. To compare the effectiveness of remote monitoring of INR using the CoaguChek® INRange coagulometer in patients who have undergone mechanical heart valve implantation with traditional INR control by measuring it in the outpatient department laboratory. Materials and methods. A prospective study enrolled 101 patients receiving warfarin after a mitral or aortic mechanical heart valve prosthesis implantation. In Group 1 (n=51), conventional laboratory INR control was used; in Group 2 (n=50), patients monitored INR by themselves using a CoaguChek® INRange coagulometer. The follow-up duration was 1 year. Results. Patients in Groups 1 and 2 did not differ in INR: 2.62 [2.45; 2.85] vs 2.6 [2.5; 2.8], respectively (data are presented as the median [1st to 3rd quartile]), and the time of INR in the therapeutic range: 66.7% [50; 78.6] vs 67.7% [53.2; 80.6]. The intervals between INR determinations in Group 1 were significantly longer: 30.5 [29.5; 31] days vs 20 [13; 25] days. Conclusion. The CoaguChek® INRange system enables remote patient monitoring during continuous warfarin therapy and achievement of the target INR with a time in the therapeutic range comparable to that for patients with INR measurements in outpatient laboratories.