Activated Partial Thromboplastin Time and Outcome After Thrombolytic Therapy for Acute Myocardial Infarction

Abstract

Although the relationship between aPTT and clinical outcome was confounded to some degree by the influence of baseline prognostic characteristics, aPTTs higher than 70 seconds were found to be associated with higher likelihood of mortality, stroke, bleeding, and reinfarction. These findings suggest that until proven otherwise, we should consider the aPTT range of 50 to 70 seconds as optimal with intravenous heparin after thrombolytic therapy.

Point of care and central laboratory determinations of the aPTT are not interchangeable in surgical intensive care patients

“…The agreement between POC aPTT and central laboratory aPTT in controls were found to be better, confirming previous data. [1][2][3][4][5][6][7][11][12][13][14] Our results are partly in line with other studies which have evaluated POC in cardiac surgery patients. Reich et al 8 studied 141 patients and considered an accuracy of ± 10% and a precision of ± 25% as clinically acceptable.…”

“…[1][2][3][4] Such delays hinder rapid diagnosis of coagulation disorders and adequate anticoagulation to be achieved rapidly. Rapid knowledge of aPTT results should allow the implementation of measures to decrease bleeding as well as the prevention of thrombotic complications.…”

The impact of bleeding in patients with acute coronary syndromes: How to optimize the benefits of treatment and minimize the risk

“…Excessive anticoagulation with heparin resulting in activated partial thromboplastin time levels above the therapeutic range is not only associated with increased bleeding, but also with an excess of recurrent ischemic events (34). The use of enoxaparin in older patients in the ASsessment of the Safety and Efficacy of a New Thrombolytic regimen (ASSENT)-3 trial (35) was associated with increased intracranial hemorrhage, but the Enoxaparin and Thrombosis Reperfusion for Acute myocardial infarCtion Treatment (ExTRACT) trial (36) showed a reduced-dosage regimen of enoxaparin to be safe in elderly patients (37).…”

Atherothrombotic Disorders

“…41 Activated Clotting Time ACT measurements are performed to monitor unfractionated heparin therapy during coronary angioplasty and bypass surgery. During angioplasty, values Ͻ250 seconds are associated with an increased incidence of major complications.…”