PMID- 31243789
OWN - NLM
STAT- MEDLINE
DCOM- 20200310
LR  - 20200310
IS  - 1096-8652 (Electronic)
IS  - 0361-8609 (Linking)
VI  - 94
IP  - 9
DP  - 2019 Sep
TI  - Clinical outcomes with unfractionated heparin monitored by anti-factor Xa vs. 
      activated partial Thromboplastin time.
PG  - 1015-1019
LID - 10.1002/ajh.25565 [doi]
AB  - Anti-factor Xa (anti-Xa) monitoring of unfractionated heparin (UFH) is associated 
      with less time to achieve therapeutic anticoagulation compared to the activated 
      partial thromboplastin time (aPTT). However, it is unknown whether clinical 
      outcomes differ between these methods of monitoring. The aim of this research was 
      to compare the rate of venous thrombosis and bleeding events in patients that 
      received UFH monitored by anti-Xa compared to the aPTT. A retrospective review of 
      electronic health records identified adult patients that received UFH given 
      intravenously (IV) for >/=2 days, with either anti-Xa or aPTT monitoring at an 
      academic tertiary care hospital. This was a pre/post study design conducted 
      between January 1 to December 30, 2014 (aPTT), and January 1 to December 30, 2016 
      (anti-Xa). All UFH adjustments were based on institutional nomograms. The primary 
      outcome was venous thrombosis and the secondary outcome was bleeding, both of 
      which occurred between UFH administration and discharge from the index 
      hospitalization. A total of 2500 patients were in the anti-Xa group and 2847 
      patients aPTT group. Venous thrombosis occurred in 10.2% vs 10.8% of patients in 
      the anti-Xa and aPTT groups, respectively (P = .49). Bleeding occurred in 33.7% 
      vs 33.6% of patients in the anti-Xa and aPTT groups, respectively (P = .94). 
      Anti-Xa monitoring was not an independent predictor of either outcome in 
      multivariate logistic regression analyses. Our study found no difference in 
      clinical outcomes between anti-Xa and aPTT-based monitoring of UFH IV.
CI  - (c) 2019 Wiley Periodicals, Inc.
FAU - Coons, James C
AU  - Coons JC
AUID- ORCID: 0000-0002-7193-3751
AD  - Department of Pharmacy and Therapeutics, University of Pittsburgh School of 
      Pharmacy, Pittsburgh, Pennsylvania.
AD  - Department of Pharmacy and Therapeutics, UPMC Presbyterian-Shadyside Hospital, 
      Pittsburgh, Pennsylvania.
FAU - Iasella, Carlo J
AU  - Iasella CJ
AD  - Department of Pharmacy and Therapeutics, University of Pittsburgh School of 
      Pharmacy, Pittsburgh, Pennsylvania.
AD  - Department of Pharmacy and Therapeutics, UPMC Presbyterian-Shadyside Hospital, 
      Pittsburgh, Pennsylvania.
FAU - Thornberg, Megan
AU  - Thornberg M
AD  - Department of Pharmacy and Therapeutics, University of Pittsburgh School of 
      Pharmacy, Pittsburgh, Pennsylvania.
FAU - Fitzmaurice, Mary Grace
AU  - Fitzmaurice MG
AD  - Department of Pharmacy and Therapeutics, University of Pittsburgh School of 
      Pharmacy, Pittsburgh, Pennsylvania.
FAU - Goehring, Kimberly
AU  - Goehring K
AUID- ORCID: 0000-0002-2685-3672
AD  - Department of Pharmacy and Therapeutics, University of Pittsburgh School of 
      Pharmacy, Pittsburgh, Pennsylvania.
FAU - Jablonski, Lindsay
AU  - Jablonski L
AD  - Department of Pharmacy and Therapeutics, University of Pittsburgh School of 
      Pharmacy, Pittsburgh, Pennsylvania.
FAU - Leader, Dominic
AU  - Leader D
AD  - Department of Pharmacy and Therapeutics, University of Pittsburgh School of 
      Pharmacy, Pittsburgh, Pennsylvania.
FAU - Meyer, Abby
AU  - Meyer A
AD  - Department of Pharmacy and Therapeutics, University of Pittsburgh School of 
      Pharmacy, Pittsburgh, Pennsylvania.
FAU - Seo, Hangil
AU  - Seo H
AD  - Department of Pharmacy and Therapeutics, University of Pittsburgh School of 
      Pharmacy, Pittsburgh, Pennsylvania.
FAU - Benedict, Neal J
AU  - Benedict NJ
AD  - Department of Pharmacy and Therapeutics, University of Pittsburgh School of 
      Pharmacy, Pittsburgh, Pennsylvania.
AD  - Department of Pharmacy and Therapeutics, UPMC Presbyterian-Shadyside Hospital, 
      Pittsburgh, Pennsylvania.
FAU - Smith, Roy E
AU  - Smith RE
AD  - Department of Pharmacy and Therapeutics, UPMC Presbyterian-Shadyside Hospital, 
      Pittsburgh, Pennsylvania.
AD  - Hematology/Oncology Division, UPMC Presbyterian-Shadyside Hospital, Pittsburgh, 
      Pennsylvania.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20190716
PL  - United States
TA  - Am J Hematol
JT  - American journal of hematology
JID - 7610369
RN  - 0 (Factor Xa Inhibitors)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - *Drug Monitoring
MH  - Factor Xa Inhibitors/*administration & dosage/adverse effects/*pharmacokinetics
MH  - Female
MH  - Hemorrhage/blood/chemically induced
MH  - Heparin/*administration & dosage/adverse effects/*pharmacokinetics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Partial Thromboplastin Time
MH  - Retrospective Studies
MH  - Venous Thrombosis/blood/chemically induced
EDAT- 2019/06/28 06:00
MHDA- 2020/03/11 06:00
CRDT- 2019/06/28 06:00
PHST- 2019/01/30 00:00 [received]
PHST- 2019/06/14 00:00 [revised]
PHST- 2019/06/24 00:00 [accepted]
PHST- 2019/06/28 06:00 [pubmed]
PHST- 2020/03/11 06:00 [medline]
PHST- 2019/06/28 06:00 [entrez]
AID - 10.1002/ajh.25565 [doi]
PST - ppublish
SO  - Am J Hematol. 2019 Sep;94(9):1015-1019. doi: 10.1002/ajh.25565. Epub 2019 Jul 16.