CTAD as a universal anticoagulant

Yokota, Masaharu; Tatsumi, Noriyuki; Izumi, Tohru; Nishioka, Toyohiro; Takubo, Takayuki

doi:10.1155/s1463924603000038

Cited by 12 publications

(13 citation statements)

References 3 publications

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“…Human biochemistry profiles showed that similar values were obtained in sera and CTAD plasmas for total proteins, albumin, total bilirubin, urea, creatinine, AST, ALT, CK, glucose and potassium, whereas the values for Na and Cl differed notably, 1 which is consistent with the input of Na ions derived from the sodium citrate in the CTAD solution. In this study, biochemistry results obtained in CTAD were compared with heparin plasma and not to serum, because it is the specimen used in our institution.…”

Section: Discussionsupporting

confidence: 67%

“…In human medicine, PT, APTT and fibrinogen measurements in citrate and CTAD plasmas were very similar and highly correlated (r >0.92). 1 In our study, plasma coagulation test results for PT, APTT, fibrinogen and AT were usually close, even though they were sometimes statistically different. Very few clinical misclassifications were observed for PT and AT.…”

Section: Discussionsupporting

confidence: 49%

“…This causes a sequestration of Ca 2+ thereby preventing platelet adhesion, activation and aggregation. 1 In vitro studies have demonstrated platelet inactivation by CTAD via decreased expression of CD62P (P Selectine) and CD63 molecules on the platelet surface. [8][9][10] In cats, the mechanisms of CTAD inactivation of platelets are not well known but are likely similar to those described in humans.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of different anticoagulant associations on haemostasis and biochemical analyses in feline blood specimens

Granat

Monzali²,

Jeunesse

et al. 2016

Journal of Feline Medicine and Surgery

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Objectives Universal anticoagulant could be an alternative to the multiple blood sampling required for clinical pathology investigations in cats. An association of citrate, theophylline, adenosine and dipyridamole (CTAD) has been reported to be a good substitute for EDTA for haematology analysis in cats, limiting platelet clumping, and has also been shown to be valid for haematology, secondary haemostasis and some biochemical variables in humans. The aim of the study was therefore to investigate the effects of CTAD on in vitro platelet aggregation and compare results of secondary haemostasis and biochemistry tests, excluding a priori those variables not reliably measured in CTAD, such as sodium, chloride and divalent cations, in feline blood specimens collected in CTAD and paired citrate and heparin tubes. Methods Thirty blood specimens sampled in citrate and CTAD were analysed for in vitro platelet aggregation, and 60 blood specimens sampled in citrate or heparin and CTAD were analysed for plasma coagulation and a biochemistry panel. Results In vitro platelet aggregation was inhibited in CTAD compared with citrate specimens. Prothrombin time, activated partial thromboplastin time, antithrombin and fibrinogen results were similar, despite some significant differences. Measurements of triglycerides, cholesterol, glucose, urea, creatinine, phosphate, total proteins and alanine aminotransferase activity were similar and well correlated in CTAD and heparin plasmas, despite some significant differences and moderate biases. Albumin showed a marked positive proportional bias, and creatine kinase and alkaline phosphatase activities a moderate and marked negative mixed bias, respectively, but could be measured in CTAD if new reference intervals were calculated. Aspartate aminotransferase activity showed a marked negative proportional bias, along with a poor correlation and some clinical misclassifications just like the potassium concentration, and thus cannot be recommended to be measured in CTAD specimens. Conclusions and relevance In cats, CTAD cannot be used for primary haemostasis investigation but could be a suitable (almost) universal anticoagulant for routine haematology, as well as for plasma coagulation and many biochemistry variables.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

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Comparison of different anticoagulant associations on haemostasis and biochemical analyses in feline blood specimens

Granat

Monzali²,

Jeunesse

et al. 2016

Journal of Feline Medicine and Surgery

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“…In practice, this study is difficult to conduct, and the GFHC co-opts the current 10% factor and recommends caution if the sample is analyzed more than three hours after sampling. The CTAD mixture is another commonly used EDTA-alternative, and several studies have shown that this anticoagulant is a good solution when dealing with platelet clumping with EDTA [59][60][61]. The long-term stability of the platelet count is better, but the problem of dilution persists, not mentioning the increased cost.…”

Section: Alternatives To Edtamentioning

confidence: 99%

Platelet Counting: Ugly Traps and Good Advice. Proposals from the French-Speaking Cellular Hematology Group (GFHC)

Baccini

Geneviève

Jacqmin

et al. 2020

JCM

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Despite the ongoing development of automated hematology analyzers to optimize complete blood count results, platelet count still suffers from pre-analytical or analytical pitfalls, including EDTA-induced pseudothrombocytopenia. Although most of these interferences are widely known, laboratory practices remain highly heterogeneous. In order to harmonize and standardize cellular hematology practices, the French-speaking Cellular Hematology Group (GFHC) wants to focus on interferences that could affect the platelet count and to detail the verification steps with minimal recommendations, taking into account the different technologies employed nowadays. The conclusions of the GFHC presented here met with a "strong professional agreement" and are explained with their rationale to define the course of actions, in case thrombocytopenia or thrombocytosis is detected. They are proposed as minimum recommendations to be used by each specialist in laboratory medicine who remains free to use more restrictive guidelines based on the patient's condition.

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“…A preliminary study in humans 19 showed that CTAD (citrate–theophylline–adenosine–dipyridamole) specimens gave similar results to EDTA specimens for the complete blood cell count (CBC), close to citrate specimens for secondary hemostasis variables (i.e., prothrombin time [PT], activated partial thromboplastin time [APTT], and fibrinogen), and close to plasma specimens for many biochemistry variables (i.e., total proteins, albumin, total bilirubin, urea, creatinine, aspartate aminotransferase [AST], alanine aminotransferase [ALT], creatine kinase [CK], glucose, and potassium), whereas the values for Na and Cl differed notably; both showed unacceptable biases because of the presence of sodium in CTAD and because testing for divalent cations was prevented by the formation of citrate salts. Moreover, CTAD has been shown to be a good substitute for EDTA in feline hematology as it limits platelet clumping and thus provides a more accurate platelet count.…”

mentioning

confidence: 99%

Evaluation of CTAD (citrate–theophylline–adenosine–dipyridamole) as a universal anticoagulant in dogs

et al. 2017

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CTAD (citrate-theophylline-adenosine-dipyridamole) has been shown to be an almost universal anticoagulant in human and feline medicine, allowing most hematology, coagulation, and biochemical analyses. Forty canine blood specimens were collected in CTAD, EDTA, heparin, and citrate for hematology, biochemistry, and coagulation analyses. CTAD partially limited platelet aggregation observed in EDTA blood smears. CTAD specimens gave similar and well-correlated results for most variables of a complete blood cell count, except for mean corpuscular volume, which was moderately higher, and mean corpuscular hemoglobin concentration, which was moderately lower in CTAD than in EDTA; reticulocyte and platelet indexes were poorly correlated. CTAD plasma gave similar results to citrate for fibrinogen, antithrombin, and D-dimers, and relatively similar results for prothrombin time, but activated partial thromboplastin time was poorly correlated. Triglycerides, cholesterol, glucose, total proteins, phosphate, iron, alanine aminotransferase, γ-glutamyl transferase, and lipase were similar and well correlated in CTAD and heparin plasmas. Urea, creatinine, albumin, alkaline phosphatase, amylase, and aspartate aminotransferase showed moderate-to-marked bias, but these variables could be measured in CTAD plasma if new reference intervals were determined. Creatine kinase activity, potassium, chloride, and total carbon dioxide measurements are not recommended in CTAD plasma. CTAD is a prospective candidate as an almost universal anticoagulant for routine hematology, some plasma coagulation, and many biochemistry variables in dogs. Definitive recommendations will require study of abnormal canine blood specimens.

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CTAD as a universal anticoagulant

Cited by 12 publications

References 3 publications

Comparison of different anticoagulant associations on haemostasis and biochemical analyses in feline blood specimens

Comparison of different anticoagulant associations on haemostasis and biochemical analyses in feline blood specimens

Platelet Counting: Ugly Traps and Good Advice. Proposals from the French-Speaking Cellular Hematology Group (GFHC)

Evaluation of CTAD (citrate–theophylline–adenosine–dipyridamole) as a universal anticoagulant in dogs

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