scholarly journals Activated Partial Thromboplastin Time and Risk of Future Venous Thromboembolism

2008 ◽  
Vol 48 (4) ◽  
pp. 1062
Author(s):  
N.A. Zakai ◽  
T. Ohira ◽  
R. White
Keyword(s):  
Venous Thromboembolism ◽  
Partial Thromboplastin Time ◽  
Activated Partial Thromboplastin Time

Anticoagulation during Cardiopulmonary Bypass in Patients with Heparin-induced Thrombocytopenia Type II and Renal Impairment Using Heparin and the Platelet Glycoprotein IIb–IIIa Antagonist Tirofiban

2001 ◽  
Vol 94 (2) ◽  
pp. 245-251 ◽  
Author(s):  
Andreas Koster ◽  
Marian Kukucka ◽  
Friedhelm Bach ◽  
Oliver Meyer ◽  
Thomas Fischer ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Venous Thromboembolism ◽  
Platelet Aggregation ◽  
Renal Impairment ◽  
Partial Thromboplastin Time ◽  
Activated Partial Thromboplastin Time ◽  
Platelet Glycoprotein ◽  
Type Ii ◽  
Heparin Induced Thrombocytopenia ◽  
D Dimer

Background Patients with heparin-induced thrombocytopenia type II require an alternative to standard heparin anticoagulation. However, in patients with renal impairment, anticoagulation during cardiopulmonary bypass with agents such as danaparoid sodium or r-hirudin are associated with hemorrhage. Anticoagulation with unfractionated heparins combined with prostacyclin, a potent platelet aggregation inhibitor, is associated with severe hypotension. The authors investigated a new concept using unfractionated heparins after platelet inhibition with the short-acting platelet glycoprotein IIb-IIIa antagonist tirofiban. Methods Ten patients with heparin-induced thrombocytopenia type II and renal impairment were enrolled in the investigation. All had heparin-induced thrombocytopenia type II antibodies present as proved by the heparin-induced platelet aggregation assay, the heparin-platelet factor 4 enzyme-linked immunosorbent assay, or both. In all patients, preoperative anticoagulation to an activated partial thromboplastin time of 40-60 s was performed with r-hirudin. Anticoagulation during cardiopulmonary bypass was achieved with a bolus of 400 IU/kg unfractionated heparins after a bolus of tirofiban 10 microg/kg followed by an infusion of tirofiban at a rate of 0.15 microg x kg(-1) x min(-1) until 1 h before conclusion of cardiopulmonary bypass. Additional unfractionated heparins were only administered if activated clotting time decreased below 480 s. Coagulation was monitored by a abciximab-modified TEG and the adenosine diphosphate-stimulated (20 microm) platelet aggregometry. D-dimer concentrations, as a marker of venous thromboembolism, were measured before and 12, 24, and 48 h after surgery. Postoperative antithrombotic therapy was started immediately with r-hirudin to anticoagulation to an activated partial thromboplastin time of 40-60 s. Results The postoperative blood loss ranged from 110 to 520 ml. No patient needed reexploration. In no patient was there clinical evidence of thrombosis or embolism in the postoperative period or of a critical increase of the D-dimer concentrations, suggesting venous thromboembolism. Transfusion of platelets was necessary in only two patients. Conclusions The protocol is easy to perform and no increased postoperative bleeding and no thromboembolic complications occurred. The combination of unfractionated heparins and tirofiban may be an alternative to other anticoagulation strategies in patients with heparin-induced thrombocytopenia.

A shortened activated partial thromboplastin time is associated with the risk of venous thromboembolism

Blood ◽  
2004 ◽  
Vol 104 (12) ◽  
pp. 3631-3634 ◽  
Author(s):  
Armando Tripodi ◽  
Veena Chantarangkul ◽  
Ida Martinelli ◽  
Paolo Bucciarelli ◽  
Pier Mannuccio Mannucci
Keyword(s):  
Venous Thromboembolism ◽  
Partial Thromboplastin Time ◽  
Odds Ratio ◽  
Case Control Study ◽  
Coagulation Factors ◽  
Case Control ◽  
Activated Partial Thromboplastin Time ◽  
Simple Test ◽  
Coagulation Time ◽  
Control Study

Hypercoagulability due to high coagulation factors XI, VIII, IX, II, and fibrinogen is recognized as a risk factor of venous thromboembolism (VTE). These factors are cumulatively explored by the activated partial thromboplastin time (APTT). To test the hypothesis that a short APTT increases the risk of VTE, a case-control study was carried out in 605 patients referred for thrombophilia testing after documented VTE and in 1290 controls. Median APTT ratio (coagulation time of test-to-reference plasma) values were 0.97 (range: 0.75-1.41) for patients and 1.00 (range: 0.72-1.33) for controls (P < .001). In patients who had an APTT ratio smaller than the fifth percentile of the distribution in controls, the odds ratio (OR) for VTE was 2.4 (95% confidence interval [CI]: 1.7-3.6) and was independent of inherited thrombophilic abnormalities. Further statistical analyses in 193 patients and 259 controls for whom factor VIII (FVIII) levels were available showed a decrease of the OR from 2.7 (95% CI: 1.4-5.3) to 2.1 (95% CI: 1.0-4.2), indicating that the risk was only partially mediated by high FVIII levels. In conclusion, hypercoagulability detected by a shortened APTT is independently associated with VTE. This inexpensive and simple test should be considered in the evaluation of the risk of VTE.

scholarly journals Elevated activated partial thromboplastin time-based clot waveform analysis markers have strong positive association with acute venous thromboembolism

2019 ◽  
Vol 29 (2) ◽  
pp. 385-393
Author(s):  
Chuen Wen Tan ◽  
McVin Hua Heng Cheen ◽  
Heng Joo Ng ◽  
Lai Heng Lee ◽  
Sahul Hameed Ahamedulla ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Partial Thromboplastin Time ◽  
Positive Association ◽  
Analysis Data ◽  
Reference Intervals ◽  
Activated Partial Thromboplastin Time ◽  
Waveform Analysis ◽  
Control Group ◽  
Delta Change ◽  
The Mean

Introduction: A hypercoagulable state is a predisposition for venous thromboembolism (VTE). The activated partial thromboplastin time (aPTT)-based clot waveform analysis (CWA) is a global haemostatic measure but its role in assessment of hypercoagulability and thrombotic disorders is uncertain. We aimed to study the changes of CWA parameters in acute VTE. We hypothesized that patients with acute VTE would demonstrate higher CWA values than control patients without VTE and having elevated CWA parameters is associated with acute VTE. Materials and methods: Clot waveform analysis data from patients (N = 45) with objectively proven acute VTE who had an aPTT performed prior to initiation of anticoagulation were compared with controls (N = 111). The CWA parameters measured were min1, min2, max2 and delta change. Results: While the mean aPTT between VTE patients and controls did not differ (P = 0.830), the mean CWA parameters were significantly higher among VTE patients than controls (min1, P < 0.001; min2, P = 0.001; max2, P = 0.002; delta change, P < 0.001). There were significantly more cases within the VTE group exhibiting CWA values above their reference intervals than the control group (all P < 0.001), with the odds ratios for VTE of 8.0, 5.2, 4.8 and 18.6 for min1, min2, max2 and delta change, respectively (all P < 0.001). Conclusions: Patients with acute VTE had elevated aPTT-based CWA parameters than controls. Higher CWA parameters were significantly associated with acute VTE.

scholarly journals Prediction of recurrent venous thromboembolism by the activated partial thromboplastin time

2006 ◽  
Vol 4 (4) ◽  
pp. 752-756 ◽  
Author(s):  
G. HRON ◽  
S. EICHINGER ◽  
A. WELTERMANN ◽  
P. QUEHENBERGER ◽  
W. M. HALBMAYER ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Partial Thromboplastin Time ◽  
Activated Partial Thromboplastin Time ◽  
Recurrent Venous Thromboembolism

scholarly journals Activated Partial Thromboplastin Time and Risk of Future Venous Thromboembolism

2008 ◽  
Vol 121 (3) ◽  
pp. 231-238 ◽  
Author(s):  
Neil A. Zakai ◽  
Tetsuya Ohira ◽  
Richard White ◽  
Aaron R. Folsom ◽  
Mary Cushman
Keyword(s):  
Venous Thromboembolism ◽  
Partial Thromboplastin Time ◽  
Activated Partial Thromboplastin Time

Comparison of aPTT (Platelin LS®) and Dilute Russell’s Viper Venom (Viperquik LA Test®) for the Screening of Lupus Anticoagulant in Patients with Venous Thromboembolism.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4122-4122
Author(s):  
Celso A. Roprigues ◽  
Aline A. Martinez ◽  
Vania M. Morelli ◽  
Raniely C. Silveira ◽  
Maria Aparecida E. Noguti ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Partial Thromboplastin Time ◽  
Lupus Anticoagulant ◽  
Activated Partial Thromboplastin Time ◽  
Screening Tests ◽  
Clotting Time ◽  
Substantial Agreement ◽  
Confirmatory Tests ◽  
Russell’S Viper ◽  
Rule Out

Abstract INTRODUCTION: To rule out the presence of LA antibodies, two or more assays that are sensitive to these antibodies must be negative. The dilute Russell’s Viper Venom Time (dRVVT) and the activated partial thromboplastin time (aPTT) using sensitive reagents have been employed to detect LA. The aim of this study was to assess the concordance level of aPTT using Platelin LS and dRVVT as screening tests to identify LA in patients with venous thromboembolism (VTE). METHODS: 94 patients (58 women, 62%) with VTE were evaluated. The detection of circulating inhibitor with Platelin LS and dRVVT was based on a prolonged clotting time and a prolonged 1:1 mixture of sample plasma and normal pooled plasma. The confirmation of the phospholipid dependency was performed only with dRVVT. RESULTS: Among the 94 patients, an abnormal test was found in 24 patients (26%) with aPTT and in 61 patients (65%) using dRVVT. After mixing tests, aPTT ratio remained long in 25% of patients with abnormal aPTT, and in 9.8% with long dRVVT. Five patients had a prolonged mixing study identified by both tests, which resulted in a substantial agreement between the two tests (Kappa= 0.78). Confirmatory tests for LA were positive in 5 out of the 6 patients with long dRVVT mixture, resulting in a prevalence of LA detected by dRVVT of 5.3%. The 5 patients with LA detected by dRVVT also had prolonged mixture with aPTT. CONCLUSION: Our results indicate that aPTT with Platelin LS is highly associated with the presence of LA detected by dRVVT and may be suitable as a screening test for LA in patients with VTE.

Activated partial thromboplastin time monitoring in patients receiving unfractionated heparin for venous thromboembolism in relation to clinical outcomes

2009 ◽  
Vol 102 (11) ◽  
pp. 879-886 ◽  
Author(s):  
Arie Laor ◽  
Haim Bitterman ◽  
Moshe Vardi
Keyword(s):  
Venous Thromboembolism ◽  
Unfractionated Heparin ◽  
Clinical Outcomes ◽  
Partial Thromboplastin Time ◽  
Randomised Controlled Trials ◽  
Activated Partial Thromboplastin Time ◽  
Bleeding Complications ◽  
Controlled Trials ◽  
Time Duration ◽  
Randomised Controlled

SummaryVenous thromboembolism (VTE) is a prevalent and serious condition, which requires anticoagulation treatment for prolonged time duration. The use of unfractionated heparin administered intravenously or subcutaneously for acute management of VTE has been studied with favourable clinical results. Most physicians use activated partial thromboplastin time to monitor the treatment effect, in an effort to obtain better efficacy with less bleeding complications. Recent data however does not support this practice. We set to explore the medical literature for the correlation between the level of anticoagulation and the clinical outcomes. Randomised controlled trials comparing subcutaneous unfractionated heparin to any other treatment modality in patients with venous thromboembolism were obtained and a meta-analysis was performed. Seventeen reports from 15 randomised controlled trials were included. Of these, eleven included anticoagulation measurements. Seven and six trials were included in our analysis for subcutaneous and intravenous modes of administration, respectively. No correlation between the anticoagulation level and the major clinical outcomes were found, except for the initial anticoagulation measurement and the total mortality at three months, but not to death related to treatment or disease progression. In conclusion, weight-adjusted subcutaneous unfractionated heparin without anticoagulation monitoring may be feasible for patients with acute venous thromboembolism. No differences exist between intravenous and subcutaneous modes of administration with regards to the correlation between anticoagulant measures and the clinical outcomes. More research is needed to substantiate this observation.

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