At least 10% of patients with lupus anticoagulant receiving long-term warfarin therapy may have falsely high INR values, which could lead to inappropriate warfarin dosage reduction. Monitoring warfarin therapy by chromogenic factor X activity in patients with lupus anticoagulant avoids this INR artifact.
Monitoring UFH therapy over 96 hours with an HA assay costs $4.37 more than monitoring with aPTT. This modest increase may be acceptable given other advantages of the HA assay.
Use of a monitored, adjusted-dose unfractionated heparin prophylactic protocol in a laparoscopic gastric bypass patient population resulted in doses greater than those used in traditional fixed-dose protocols. However, bleeding and thromboembolism rates were very low and no patients died.
C o m p a r i s o n o f A n t i -F a c t o r X a H e p a r i n A c t i v i t y a n dA c t i v a t e d P a r t i a l T h r o m b o p l a s t i n T i m e i n 2 , 7 7 3 P l a s m a S a m p l e s F r o m U n f r a c t i o n a t e d H e p a r i n -T r e a t e d P a t i e n t s
TERRY K. ROSBOROUGH, MDThis study was conducted to evaluate two methods of determining the "therapeutic range" of the activated partial thromboplastin time (APTT) during unfractionated heparin treatment. Multiple fresh plasma samples from 694 patients treated with unfractionated heparin were tested simultaneously for APTT and anti-factor Xa heparin activity. The data were analyzed by linear regression and by a minimization-of-error technique to determine the more accurate APTT therapeutic range. The best-fit linear regression equation was obtained using logarithmically transformed APTT values. Using this equation, the
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