PMID- 26757210
OWN - NLM
STAT- MEDLINE
DCOM- 20170717
LR  - 20170817
IS  - 1439-1902 (Electronic)
IS  - 0171-6425 (Linking)
VI  - 64
IP  - 6
DP  - 2016 Sep
TI  - Antifactor Xa Activity for the Management of Anticoagulation during Cardiac 
      Surgery.
PG  - 494-500
LID - 10.1055/s-0035-1570035 [doi]
AB  - Background In patients with autoimmune diseases associated with antiphospholipid 
      antibodies, precise management of anticoagulation during extracorporeal 
      circulation (ECC) is complicated. It was the aim of the present study to 
      determine whether antifactor Xa (aXa) activity is useful in guiding heparin 
      therapy during ECC. Methods In 15 patients undergoing cardiac surgery, 
      anticoagulation with unfractionated heparin (UFH) and its reversal with protamine 
      were guided using activated clotting time (ACT) (>400 second during ECC; </=100 
      second for UFH reversal). For each ACT, the corresponding aXa activity levels 
      were measured. Results A total of 144 blood samples were obtained. ACT and aXa 
      activity were significantly correlated (r = 0.771, p< 0.0001, Spearman rank-order 
      correlation). Using receiver operating characteristic curve (ROC) analyses, the 
      cutoffvalues for aXa activity were 1.14 IU/mL (area under the ROC curve [AUC]: 
      0.89; inaccuracy rate: 9.4%) to predict ACT > 400 seconds and 0.55 IU/mL (AUC: 
      0.85; inaccuracy rate: 13.3%) for ACT </= 100 seconds. Conclusion AXa activity is 
      strongly correlated with ACT, and therefore may be feasible for managing 
      anticoagulation with UFH during ECC.
CI  - Georg Thieme Verlag KG Stuttgart . New York.
FAU - Reyher, Christian
AU  - Reyher C
AD  - Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, 
      University Hospital Frankfurt, Frankfurt am Main, Germany.
FAU - Wurfel, Claire
AU  - Wurfel C
AD  - Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, 
      University Hospital Frankfurt, Frankfurt am Main, Germany.
FAU - Lindhoff-Last, Edelgard
AU  - Lindhoff-Last E
AD  - Division of Hemostaseology, Department of Internal Medicine, University Hospital 
      Frankfurt, Frankfurt am Main, Germany.
FAU - Meybohm, Patrick
AU  - Meybohm P
AD  - Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, 
      University Hospital Frankfurt, Frankfurt am Main, Germany.
FAU - Zacharowski, Kai
AU  - Zacharowski K
AD  - Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, 
      University Hospital Frankfurt, Frankfurt am Main, Germany.
FAU - Moritz, Anton
AU  - Moritz A
AD  - Department of Thoracic and Cardiovascular Surgery, University Hospital Frankfurt, 
      Frankfurt am Main, Germany.
FAU - Schindewolf, Marc
AU  - Schindewolf M
AD  - Division of Hemostaseology, Department of Internal Medicine, University Hospital 
      Frankfurt, Frankfurt am Main, Germany.
FAU - Weber, Christian Friedrich
AU  - Weber CF
AD  - Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, 
      University Hospital Frankfurt, Frankfurt am Main, Germany.
LA  - eng
PT  - Journal Article
DEP - 20160112
PL  - Germany
TA  - Thorac Cardiovasc Surg
JT  - The Thoracic and cardiovascular surgeon
JID - 7903387
RN  - 0 (Anticoagulants)
RN  - 0 (Autoantibodies)
RN  - 0 (Biomarkers)
RN  - 0 (Heparin Antagonists)
RN  - 0 (Protamines)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.21.6 (Factor Xa)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*administration & dosage/adverse effects
MH  - Area Under Curve
MH  - Autoantibodies/*blood
MH  - Biomarkers/blood
MH  - Blood Coagulation/*drug effects
MH  - *Cardiac Surgical Procedures/adverse effects
MH  - Factor Xa/*immunology
MH  - Feasibility Studies
MH  - Female
MH  - Germany
MH  - Heparin/*administration & dosage/adverse effects
MH  - Heparin Antagonists/*administration & dosage/adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Monitoring, Intraoperative/*methods
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Protamines/*administration & dosage/adverse effects
MH  - ROC Curve
MH  - Reproducibility of Results
MH  - Whole Blood Coagulation Time
EDAT- 2016/01/13 06:00
MHDA- 2017/07/18 06:00
CRDT- 2016/01/13 06:00
PHST- 2016/01/13 06:00 [entrez]
PHST- 2016/01/13 06:00 [pubmed]
PHST- 2017/07/18 06:00 [medline]
AID - 10.1055/s-0035-1570035 [doi]
PST - ppublish
SO  - Thorac Cardiovasc Surg. 2016 Sep;64(6):494-500. doi: 10.1055/s-0035-1570035. Epub 
      2016 Jan 12.