PMID- 34562001
OWN - NLM
STAT- MEDLINE
DCOM- 20220310
LR  - 20230208
IS  - 1943-7722 (Electronic)
IS  - 0002-9173 (Print)
IS  - 0002-9173 (Linking)
VI  - 157
IP  - 3
DP  - 2022 Mar 3
TI  - From Activated Partial Thromboplastin Time to Antifactor Xa and Back Again.
PG  - 321-327
LID - 10.1093/ajcp/aqab135 [doi]
AB  - OBJECTIVES: Monitoring is essential to safe anticoagulation prescribing and 
      requires close collaboration among pathologists, clinicians, and pharmacists. 
      METHODS: We describe our experience in the evolving strategy for laboratory 
      testing of unfractionated heparin (UFH). RESULTS: An intrainstitutional 
      investigation revealed significant discordance between activated partial 
      thromboplastin time (aPTT) and antifactor Xa (anti-Xa) assays, prompting a 
      transition from the former to the latter in 2013. With the increasing use of oral 
      factor Xa inhibitors (eg, apixaban, rivaroxaban, edoxaban, betrixaban), which 
      interfere with the anti-Xa assay, we adapted our protocol again to incorporate 
      aPTT in patients admitted on oral Xa inhibitors who require transition to UFH. 
      CONCLUSIONS: Our experience demonstrates key challenges in anticoagulation and 
      highlights the importance of clinical pathologists in helping health systems 
      adapt to the changing anticoagulation landscape.
CI  - (c) American Society for Clinical Pathology, 2021. All rights reserved. For 
      permissions, please e-mail: journals.permissions@oup.com.
FAU - May, Jori E
AU  - May JE
AUID- ORCID: 0000-0001-7744-5700
AD  - Division of Hematology and Oncology, Department of Medicine, University of 
      Alabama at Birmingham, Birmingham, USA.
FAU - Siniard, Rance Chad
AU  - Siniard RC
AD  - Division of Laboratory Medicine, Department of Pathology, School of Medicine, 
      University of Alabama at Birmingham, Birmingham, USA.
FAU - Taylor, Laura J
AU  - Taylor LJ
AD  - UAB Coagulation Service, School of Medicine, University of Alabama at Birmingham, 
      Birmingham, USA.
FAU - Marques, Marisa B
AU  - Marques MB
AD  - Division of Laboratory Medicine, Department of Pathology, School of Medicine, 
      University of Alabama at Birmingham, Birmingham, USA.
FAU - Gangaraju, Radhika
AU  - Gangaraju R
AD  - Division of Hematology and Oncology, Department of Medicine, University of 
      Alabama at Birmingham, Birmingham, USA.
AD  - Institute for Cancer Outcomes and Survivorship, School of Medicine, University of 
      Alabama at Birmingham, Birmingham, USA.
LA  - eng
GR  - KL2 TR003097/TR/NCATS NIH HHS/United States
GR  - KL2TR003097/TR/NCATS NIH HHS/United States
PT  - Journal Article
PL  - England
TA  - Am J Clin Pathol
JT  - American journal of clinical pathology
JID - 0370470
RN  - 0 (Anticoagulants)
RN  - 0 (Factor Xa Inhibitors)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - *Anticoagulants/pharmacology/therapeutic use
MH  - Blood Coagulation
MH  - Drug Monitoring/methods
MH  - Factor Xa Inhibitors/therapeutic use
MH  - *Heparin/therapeutic use
MH  - Humans
MH  - Partial Thromboplastin Time
PMC - PMC8891818
OTO - NOTNLM
OT  - Anticoagulation
OT  - Direct oral anticoagulants
OT  - Heparin
EDAT- 2021/09/26 06:00
MHDA- 2022/03/11 06:00
PMCR- 2022/09/25
CRDT- 2021/09/25 08:34
PHST- 2021/04/27 00:00 [received]
PHST- 2021/07/14 00:00 [accepted]
PHST- 2021/09/26 06:00 [pubmed]
PHST- 2022/03/11 06:00 [medline]
PHST- 2021/09/25 08:34 [entrez]
PHST- 2022/09/25 00:00 [pmc-release]
AID - 6375360 [pii]
AID - aqab135 [pii]
AID - 10.1093/ajcp/aqab135 [doi]
PST - ppublish
SO  - Am J Clin Pathol. 2022 Mar 3;157(3):321-327. doi: 10.1093/ajcp/aqab135.