Journal
BLOOD COAGULATION & FIBRINOLYSIS
Volume 16, Issue 3, Pages 173-176Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/01.mbc.0000164424.90545.6e
Keywords
unfractionated heparin; enoxaparin; low molecular weight heparin; anti-activated factor X; activated partial thromboplastin time; anticoagulant; CTAD; sodium citrate
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The purpose of this study was to determine whether the anti-activated factor X (anti-FXa) assay is less affected by pre-analytical variables in monitoring patients on unfractionated heparin (UFH) and low molecular weight heparin (LMWH) than the activated partial thromboplastin time (aPTT). Forty-six subjects receiving either enoxaparin (LMWH) or UFH were randomly selected. Each study subject had six vacutainer tubes (3.8% sodium citrate, 3.2% sodium citrate) drawn by an atraumatic venipuncture. One tube from each set had a blood to anticoagulant ratio of 9 : 1. The other tube had an intentional 'short-draw' of approximately 6 : 1 blood to anticoagulant ratio. All specimens had an aPTT and a chromogenic anti-FXa assay performed on each specimen regardless of heparin type. The aPTT assay mean with the 3.8% sodium citrate tube short-draw tube was statistically different from the other aPTT assays (P = 0.06). However, all six of the mean anti-FXa assays for the UFH and LMWH heparin subjects were not statistically or clinically different (analysis of variance, P = 0.9878 for UFH and P = 0.9060 for LMWH). The intentional short-draw tube did not affect the anti-FXa assay regardless of the anticoagulant. The anti-FXa assay appears to be a better method for monitoring heparin subjects than the aPTT due to the lack of effect of pre-nalytical variables. (c) 2005 Lippincott Williams & Wilkins.
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