PMID- 20950840
OWN - NLM
STAT- MEDLINE
DCOM- 20110523
LR  - 20191210
IS  - 1879-2472 (Electronic)
IS  - 0049-3848 (Linking)
VI  - 126
IP  - 6
DP  - 2010 Dec
TI  - Monitoring treatments with unfractionated heparin: CTAD must be used instead of 
      citrate as the anticoagulant solution when using partial-draw collection tubes. 
      Results of a multicenter evaluation.
PG  - 536-42
LID - 10.1016/j.thromres.2010.08.029 [doi]
AB  - BACKGROUND: Sampling small volumes of blood may be necessary, particularly in 
      pediatric patients, or in case of difficult or recurrent venipunctures. METHODS: 
      Routine hemostasis test results evaluated in partial- and full-draw evacuated 
      polymer tubes obtained in 4 centers were compared. RESULTS: No relevant 
      discrepancy (Bland-Altman) was found between test results measured in partial- 
      and full-draw tubes obtained from untreated patients and from patients on vitamin 
      K-antagonist or low molecular weight heparin. In patients on unfractionated 
      heparin (UFH), significantly lower anti-FXa activity [median=0.29IU/mL 
      (range:0.04-1.15) vs. 0.39 (0.05-1.25), n=89, p<0.0001] and shorter aPTT were 
      measured in partial-draw tubes. This discrepancy was likely to be related to the 
      release of higher amounts of PF4 after increased platelet activation in 
      partial-draw tubes. As CTAD is known to counteract platelet activation, we then 
      collected blood into partial-draw CTAD tube and full-draw citrate tube. Both in 
      patients on UFH and in untreated patients, no relevant difference could be 
      demonstrated for all studied parameters (Bland-Altman), including aPTT and 
      anti-FXa activity, even if analytical comparison showed significantly higher 
      anti-FXa activity in partial-draw CTAD than in full-draw citrated tubes with a 
      mean bias of 0.02 IU/mL, identical throughout the measuring range. CONCLUSIONS: 
      These results suggest that samples collected into partial-draw citrate tubes 
      allow accurate routine coagulation testingin all patients but those requiring UFH 
      assessment,in which their use led to a significant underestimation 
      ofanticoagulation. In such cases, partial-draw tubes containing CTAD could be 
      validly used to monitor heparin therapy as well as to perform routine coagulation 
      testing.
CI  - Copyright (c) 2010. Published by Elsevier Ltd.
FAU - Toulon, Pierre
AU  - Toulon P
AD  - Universite Nice Sophia-Antipolis, Faculte de Medecine, CHU Saint Roch, Service 
      d'Hematologie Biologique, Nice, France. toulon.p@chu-nice.fr
FAU - Abecassis, Lien
AU  - Abecassis L
FAU - Smahi, Motalib
AU  - Smahi M
FAU - Ternisien, Catherine
AU  - Ternisien C
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20101014
PL  - United States
TA  - Thromb Res
JT  - Thrombosis research
JID - 0326377
RN  - 0 (Anticoagulants)
RN  - 0 (Citrates)
RN  - 64ALC7F90C (Dipyridamole)
RN  - 9005-49-6 (Heparin)
RN  - C137DTR5RG (Theophylline)
RN  - K72T3FS567 (Adenosine)
SB  - IM
MH  - Adenosine
MH  - Anticoagulants/*administration & dosage/*blood
MH  - Blood Coagulation Tests/*methods
MH  - Blood Specimen Collection/*methods
MH  - Citrates
MH  - Dipyridamole
MH  - Drug Monitoring/*methods
MH  - Heparin/*administration & dosage/*blood
MH  - Humans
MH  - Theophylline
EDAT- 2010/10/19 06:00
MHDA- 2011/05/24 06:00
CRDT- 2010/10/19 06:00
PHST- 2010/02/08 00:00 [received]
PHST- 2010/08/11 00:00 [revised]
PHST- 2010/08/22 00:00 [accepted]
PHST- 2010/10/19 06:00 [entrez]
PHST- 2010/10/19 06:00 [pubmed]
PHST- 2011/05/24 06:00 [medline]
AID - S0049-3848(10)00484-6 [pii]
AID - 10.1016/j.thromres.2010.08.029 [doi]
PST - ppublish
SO  - Thromb Res. 2010 Dec;126(6):536-42. doi: 10.1016/j.thromres.2010.08.029. Epub 
      2010 Oct 14.