PMID- 23615295
OWN - NLM
STAT- MEDLINE
DCOM- 20150708
LR  - 20140827
IS  - 1938-2723 (Electronic)
IS  - 1076-0296 (Linking)
VI  - 20
IP  - 7
DP  - 2014 Oct
TI  - Monitoring of unfractionated heparin using activated partial thromboplastin time: 
      an assessment of the current nomogram and analysis according to age.
PG  - 723-8
LID - 10.1177/1076029613485153 [doi]
AB  - BACKGROUND: We frequently encounter high levels of activated partial 
      thromboplastin time (aPTT) during heparin anticoagulation. The purpose of this 
      study is, first, to investigate the rate of achieving and maintaining therapeutic 
      aPTT in patients treated with heparin anticoagulation and second, to assess the 
      adequacy the current nomogram. METHODS: We included 197 patients who underwent 
      anticoagulation with unfractionated heparin (UFH) according to the standard 
      nomogram between September 2008 and May 2010. The primary endpoints were the rate 
      of achieving a therapeutic range (TR) at the first sample, 24 hours, or 48 hours. 
      We also compared heparin nomograms according to age (<70 years vs >/=70 years). 
      RESULTS: Of the 197 patients, 131 had heparin loading. In the heparin loading 
      group, there were 19.1% (n=25), 69.5% (n=91), and 90.1% (n=18) achieving TR at 
      the first aPTT, 24 hours, and 48 hours, respectively. The therapeutic aPTT 
      proportion was 39.2%, and the rate of peak level above 90 seconds was 93.1%. Peak 
      levels of aPTT were higher in the older age group than in the younger age group 
      (202.3 +/- 124.2 versus 152.0 +/- 78.9, p=0.007). CONCLUSION: Our results indicate a 
      high rate of achieving therapeutic aPTT at 24 hous and 48 hours, but a low 
      success rate for maintenance within the TR. Most patients had supratherapeutic 
      aPTT of more than 90 seconds. Therefore, the TR of aPTT that matches heparin 
      levels of 0.3 to 0.7 IU/mL measured by antifactor Xa assay should be determined. 
      If not, we should consider adopting a new heparin dosing nomogram.
CI  - (c) The Author(s) 2013.
FAU - Kim, Je Sang
AU  - Kim JS
AD  - Division of Cardiology, Department of Internal Medicine, Sejong General Hospital, 
      Bucheon-si, Korea.
FAU - Lee, Hyun Jong
AU  - Lee HJ
AD  - Division of Cardiology, Department of Internal Medicine, Sejong General Hospital, 
      Bucheon-si, Korea.
FAU - Sung, Ji Dong
AU  - Sung JD
AD  - Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, 
      Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
FAU - Kim, Hee-Jin
AU  - Kim HJ
AD  - Department of Laboratory Medicine and Genetics, Samsung Medical Center 
      Sungkyunkwan University School of Medicine, Seoul, Korea.
FAU - Lee, Soo-Youn
AU  - Lee SY
AD  - Department of Laboratory Medicine and Genetics, Samsung Medical Center 
      Sungkyunkwan University School of Medicine, Seoul, Korea juneskim@skku.edu 
      sy117.lee@samsung.com.
FAU - Kim, June Soo
AU  - Kim JS
AD  - Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, 
      Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 
      juneskim@skku.edu sy117.lee@samsung.com.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20130423
PL  - United States
TA  - Clin Appl Thromb Hemost
JT  - Clinical and applied thrombosis/hemostasis : official journal of the 
      International Academy of Clinical and Applied Thrombosis/Hemostasis
JID - 9508125
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Anticoagulants/administration & dosage/*pharmacokinetics
MH  - Drug Monitoring/*methods
MH  - Female
MH  - Heparin/administration & dosage/*pharmacokinetics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Partial Thromboplastin Time
MH  - Retrospective Studies
OTO - NOTNLM
OT  - activated partial thromboplastin time
OT  - nomogram
OT  - unfractionated heparin
EDAT- 2013/04/26 06:00
MHDA- 2015/07/15 06:00
CRDT- 2013/04/26 06:00
PHST- 2013/04/26 06:00 [entrez]
PHST- 2013/04/26 06:00 [pubmed]
PHST- 2015/07/15 06:00 [medline]
AID - 1076029613485153 [pii]
AID - 10.1177/1076029613485153 [doi]
PST - ppublish
SO  - Clin Appl Thromb Hemost. 2014 Oct;20(7):723-8. doi: 10.1177/1076029613485153. 
      Epub 2013 Apr 23.