Performance of Anti-Factor Xa Versus Activated Partial Thromboplastin Time for Heparin Monitoring Using Multiple Nomograms

被引：51

作者：

Whitman-Purves, Emily ^{[1
]}

Coons, James C. ^{[1
,2
]}

Miller, Taylor ^{[1
]}

DiNella, Jeannine V. ^{[1
]}

Althouse, Andrew ^{[1
]}

Schmidhofer, Mark ^{[1
]}

Smith, Roy E. ^{[1
]}

机构：

[1] Univ Pittsburgh, Presbyterian Shadyside Hosp, Med Ctr UPMC, 727 Salk Hall,3501 Terrace St, Pittsburgh, PA 15261 USA

[2] Univ Pittsburgh, Dept Pharm & Therapeut, Sch Pharm, 727 Salk Hall,3501 Terrace St, Pittsburgh, PA 15261 USA

来源：

CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS | 2018年 / 24卷 / 02期

关键词：

anti-factor Xa; unfractionated heparin; anticoagulation; THERAPY; APTT;

D O I：

10.1177/1076029617741363

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The purpose of this study was to compare the performance of anti-factor Xa concentration versus activated partial thromboplastin time (aPTT) monitoring with multiple indication-specific heparin nomograms. This was a prospective, nonrandomized study with historical control at a large academic medical center. A total of 201 patients who received intravenous heparin in the cardiology units were included. The prospective cohort included patients (n = 101) with anti-factor Xa (anti-Xa) monitoring, and the historical control group included patients (n = 100) who had aPTT monitoring. Patients in the prospective group had both anti-Xa and aPTT samples drawn, but anti-Xa was used for dosing adjustment. The anti-Xa cohort achieved a significantly faster time to therapeutic range (P < .01) and required fewer dose adjustments per 24-hour period compared to the aPTT control (P = .01). Results were consistent across heparin nomograms. The overall discordance rate between the 2 tests was 49%. No significant differences in clinical outcomes were observed. In summary, anti-Xa monitoring improved the time to therapeutic anticoagulation and led to fewer dose adjustments compared to the aPTT with multiple indication-based heparin nomograms.

引用

页码：310 / 316

页数：7

共 15 条

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