PMID- 26272899
OWN - NLM
STAT- MEDLINE
DCOM- 20160512
LR  - 20190101
IS  - 1535-2900 (Electronic)
IS  - 1079-2082 (Linking)
VI  - 72
IP  - 17 Suppl 2
DP  - 2015 Sep 1
TI  - Comparison of unfractionated heparin protocols using antifactor Xa monitoring or 
      activated partial thrombin time monitoring.
PG  - S90-7
LID - 10.2146/sp150016 [doi]
AB  - OBJECTIVE: To determine whether there is a difference between an activated 
      partial thromboplastin time (aPTT) based unfractionated heparin (UFH) protocol 
      versus an antifactor Xa based UFH protocol with respect to 24-hour attainment of 
      therapeutic levels. METHODS: This was an observational study performed at a 500 
      bed private, community hospital. The study included inpatients from January 2008 
      to December 2009 on our institution's aPTT UFH protocol and inpatients from July 
      2010 to March 2011 on our institution's antifactor Xa UFH protocol. The two 
      groups were compared to determine whether a higher percentage of patients reached 
      therapeutic goal within 24 hours of UFH initiation. Secondary outcomes evaluated 
      the percentage of patients at therapeutic goal within 6 and 12 hours, incidence 
      of bleeding, and number of UFH dosage adjustments within 24 hours between the two 
      groups. RESULTS: One hundred twenty-one patients met inclusion criteria for this 
      study; 79 in the aPTT group and 42 in the antifactor Xa group. At 24 hours, 74% 
      of patients in the antifactor Xa group were at goal, versus 63% of patients in 
      the aPTT group (p = 0.242). Nearly 57% of patients in the antifactor Xa group 
      were at goal versus 27% in the aPTT group within 6 hours (p = 0.001). Subjects in 
      the antifactor Xa group averaged 1.00 dosage adjustments per subject as compared 
      to an 1.71 dosage adjustments per subject in the aPTT group within the first 24 
      hours (p = 0.003). CONCLUSION: The antifactor Xa assay should be used to monitor 
      UFH versus aPTT due to less variability in measurements, the absence of a need 
      for calibration with new reagents/coagulometers, quicker attainment of 
      therapeutic levels, fewer dose adjustments, and similar bleeding rates.
CI  - Copyright (c) 2015 by the American Society of Health-System Pharmacists, Inc. All 
      rights reserved.
FAU - Fruge, Kristian S
AU  - Fruge KS
AD  - Clinical Pharmacist, Our Lady of the Lake Regional Medical Center, Baton Rouge, 
      LA.
FAU - Lee, Young R
AU  - Lee YR
AD  - Assistant Professor of Pharmacy Practice, Texas Tech University of Health 
      Sciences Center School of Pharmacy, Abilene, TX young.lee@ttuhsc.edu.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - Am J Health Syst Pharm
JT  - American journal of health-system pharmacy : AJHP : official journal of the 
      American Society of Health-System Pharmacists
JID - 9503023
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.21.6 (Factor Xa)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/*administration & dosage
MH  - Blood Coagulation Tests/*methods
MH  - *Clinical Protocols
MH  - Factor Xa
MH  - Female
MH  - Heparin/*administration & dosage
MH  - Hospital Bed Capacity, 500 and over
MH  - Hospitals, Community
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Partial Thromboplastin Time
MH  - Retrospective Studies
EDAT- 2015/08/15 06:00
MHDA- 2016/05/14 06:00
CRDT- 2015/08/15 06:00
PHST- 2015/08/15 06:00 [entrez]
PHST- 2015/08/15 06:00 [pubmed]
PHST- 2016/05/14 06:00 [medline]
AID - 72/17_Supplement_2/S90 [pii]
AID - 10.2146/sp150016 [doi]
PST - ppublish
SO  - Am J Health Syst Pharm. 2015 Sep 1;72(17 Suppl 2):S90-7. doi: 10.2146/sp150016.