Comparing Anti-Factor Xa and Activated Partial Thromboplastin Levels for Monitoring Unfractionated Heparin

The Annals of Pharmacotherapy
Rebekah A WahkingKelly W Davis

Abstract

Background: Lab tests such as activated partial thromboplastin time (aPTT) or anti-factor Xa (anti-Xa) levels are typically used to monitor intravenous unfractionated heparin (IV heparin), with recent evidence suggesting that anti-Xa levels may provide a more accurate measure of anticoagulation. Objective: The Lexington Veterans Affairs Health Care System transitioned from using aPTT to anti-Xa levels in January 2017. This study was conducted to evaluate the efficacy and safety of this change. Methods: This was a retrospective cohort study comparing all patients receiving IV heparin per protocol for at least 24 hours from August 1, 2016, to January 31, 2017 (aPTT group), and February 1, 2017, to July 31, 2017 (anti-Xa group). The primary objective was a comparison of IV heparin doses required to achieve goal range between the 2 cohorts. Secondary objectives included a comparison of time to therapeutic goal, percentage of time within goal range, number of rate changes until therapeutic goal, and adverse outcomes, such as number of bleeds. Results: A total of 155 patients were included in this study. Significantly higher IV heparin doses were required to achieve therapeutic goal in the anti-Xa group, despite significantly fewer I...Continue Reading

References

Apr 22, 1996·Archives of Internal Medicine·N R CampbellG E Raskob
Aug 13, 2004·Journal of Thrombosis and Thrombolysis·Michael S LeeJudith S Hochman
Nov 3, 2006·Thrombosis and Haemostasis·John W Eikelboom, Jack Hirsh
Apr 26, 2013·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Je Sang KimJune Soo Kim
Aug 15, 2015·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Kristian S Frugé, Young R Lee
Jan 19, 2016·Journal of Thrombosis and Thrombolysis·Maureen A SmytheAnn K Wittkowsky
Dec 8, 2017·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Emily Whitman-PurvesRoy E Smith

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Citations

Nov 12, 2020·Scientific Reports·Keiko HikinoSatoshi Nakagawa

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