Antifactor Xa levels vs. activated partial thromboplastin time for monitoring unfractionated heparin. A pilot study

Samuel, Sophie; Allison, Teresa A.; Sharaf, Sherouk; Yau, Gin; Ranjbar, Ghazaleh; Mckaig, N.; Nguyen, Andy; Escobar, Miguel A.; Choi, H. Alex

doi:10.1111/jcpt.12415

Cited by 47 publications

(53 citation statements)

References 19 publications

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“…Based on the limited SARS-CoV-2 data and our own experience, we suggest to monitor the heparin activity of UFH treatment based on anti-Xa levels with a target value of 0.3 -0.7 U/L in all patients with SARS-CoV-2 instead of treatment based on aPTT levels 5,6,7 .…”

Section: Accepted Articlementioning

confidence: 99%

Thromboembolic events and apparent heparin resistance in patients infected with SARS‐CoV‐2

Beun

Kuşadasi

Sikma

et al. 2020

Int J Lab Hematology

162

188

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Section: Accepted Articlementioning

confidence: 99%

Thromboembolic events and apparent heparin resistance in patients infected with SARS‐CoV‐2

Beun

Kuşadasi

Sikma

et al. 2020

Int J Lab Hematology

162

188

View full text Add to dashboard Cite

“…While anti‐Xa activity was elevated after LMWH administration, an associated prolongation in APTT was also evident. In the literature, there were studies reporting that APTT and anti‐Xa activity did not correlate with one another in the UFH‐treated patients . In contrast, there is a paucity of data about the relationship between these two indices in the patients after LMWH administration, especially in the context of anticoagulation for haemodialysis.…”

mentioning

confidence: 99%

“…In the literature, there were studies reporting that APTT and anti-Xa activity did not correlate with one another in the UFH-treated patients. [4][5][6][7] In contrast, there is a paucity of data about the relationship between these two indices in the patients after LMWH administration, especially in the context of anticoagulation for haemodialysis. In this report, the data collected in our trials were re-examined to see if a meaningful correlation between APTT and anti-Xa activity existed in the dialysis patients who received LMWH as anticoagulation.…”

mentioning

confidence: 99%

Correlation between activated partial thromboplastin time and anti‐Xa activity in patients who received low‐molecular weight heparin as anticoagulation for haemodialysis

et al. 2017

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Plasma anti-Xa activity, the recommended test to monitor low-molecular weight heparin (LMWH) therapy, is not readily available in many laboratories. In our clinical trials on the use of LMWH as anticoagulation for haemodialysis, a consistent prolongation of APTT in addition to the elevated anti-Xa activity was observed in the patients after LMWH administration. Hence, the paired anti-Xa activity and APTT data were re-analyzed. The APTT ratio, which was the proportional change in APTT from the baseline value after LMWH administration, was found to have a strong correlation with anti-Xa activity (coefficient of determination, R = 0.72, P< 0.001). In the receiver operating characteristic analysis, the APTT ratio was also found to be an excellent predictor of therapeutic anti-Xa activity ≧0.5 IU/mL (area under curve = 0.93, P < 0.001). The sensitivity was 88% and the specificity was 83.3% when an APTT ratio ≧1.4 was used as the cut point to predict the achievement of therapeutic anti-Xa activity. Our results illustrated that APTT is a potentially useful screening test to assess the degree of anticoagulation achieved by LMWH during haemodialysis, if the testing for plasma anti-Xa activity is not available.

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“…Another study was done by Samuel et al (Samuel et al 2016) showed in their pilot study that when comparing aPTT and anti-Xa, results showed that therapeutic range (> 50-100% of the time) was achieved in only 5 (10%) patients in the aPTT group vs. 21 (57%) in the anti-Xa group; P < 0•01.…”

Section: Discussionmentioning

confidence: 99%

The use of activated partial thromboplastin time versus antifactor Xa assay in monitoring continuous unfractionated heparin infusion therapy in obstetric intensive care unit

Zaki

Elbeialy

Soliman

2019

Ain-Shams J Anesthesiol

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Background: Unfractionated heparin (UFH) infusion therapy needs accurate tight control to prevent overanticoagulation that may result in hemorrhagic complications and also to prevent sub therapeutic level that may result in thrombotic complications. The aim of this study was to compare the most popular monitoring tool activated aPTT versus antifactor Xa to reach accurate monitor to UFH therapy in critically ill pregnant females. Results: Time to reach therapeutic level as well as total heparin dose required to reach this therapeutic level were much lower in the anti-Xa group when compared to aPTT group. Conclusion: The use of anti-Xa-based protocol to monitor UFH infusion therapy resulted in better therapeutic control as it resulted in earlier achievement of therapeutic level and lower heparin dose requitments.

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Antifactor Xa levels vs. activated partial thromboplastin time for monitoring unfractionated heparin. A pilot study

Cited by 47 publications

References 19 publications

Thromboembolic events and apparent heparin resistance in patients infected with SARS‐CoV‐2

Thromboembolic events and apparent heparin resistance in patients infected with SARS‐CoV‐2

Correlation between activated partial thromboplastin time and anti‐Xa activity in patients who received low‐molecular weight heparin as anticoagulation for haemodialysis

The use of activated partial thromboplastin time versus antifactor Xa assay in monitoring continuous unfractionated heparin infusion therapy in obstetric intensive care unit

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