PMID- 34678527
OWN - NLM
STAT- MEDLINE
DCOM- 20211222
LR  - 20221116
IS  - 1879-2472 (Electronic)
IS  - 0049-3848 (Linking)
VI  - 208
DP  - 2021 Dec
TI  - Comparison of clinical outcomes using activated partial thromboplastin time 
      versus antifactor-Xa for monitoring therapeutic unfractionated heparin: A 
      systematic review and meta-analysis.
PG  - 18-25
LID - S0049-3848(21)00482-5 [pii]
LID - 10.1016/j.thromres.2021.10.010 [doi]
AB  - INTRODUCTION: Continuous intravenous unfractionated heparin (UFH) is a mainstay 
      of therapeutic anticoagulation in the acute setting. The two most common 
      laboratory tests for monitoring UFH are the activated partial thromboplastin time 
      (aPTT) and antifactor Xa (anti-Xa) heparin assay. We reviewed the available 
      evidence to evaluate if the choice of monitoring test for UFH therapy is 
      associated with a difference in the clinical outcomes of bleeding, thrombosis, or 
      mortality. MATERIALS AND METHODS: MEDLINE, Cochrane database, and conference 
      abstracts from the Society of Critical Care Medicine, the American Society of 
      Hematology, and the American College of Clinical Pharmacy were searched for all 
      studies comparing aPTT and anti-Xa monitoring for therapeutic UFH that evaluated 
      outcomes for bleeding, thrombotic events, or mortality. Risk of bias was assessed 
      with the Cochrane Risk of Bias Tool and Newcastle Ottawa Scale. Pooled relative 
      risk ratios were calculated using an inverse variance-weighted random-effects 
      model. RESULTS: Ten studies (n = 6677) were included for analysis. The use of 
      anti-Xa compared to aPTT was not associated with an increased risk of bleeding 
      (RR 1.03; 95% CI 0.8-1.22 I(2) = 4%) or an increased risk of thrombotic events 
      (RR 0.99; 95% CI 0.76-1.30, I(2) = 3%). There was no difference in mortality 
      within individual studies but the data were not suitable for pooled analysis. 
      CONCLUSIONS: Pooled data comparing aPTT vs. anti-Xa for monitoring therapeutic 
      UFH did not suggest differences in the outcomes of bleeding or thrombosis.
CI  - Copyright (c) 2021 Elsevier Ltd. All rights reserved.
FAU - Swayngim, Rebecca
AU  - Swayngim R
AD  - Department of Pharmacy, Denver Health Medical Center, 777 Bannock St, Denver 
      80204, CO, USA. Electronic address: Rebecca.Swayngim@dhha.org.
FAU - Preslaski, Candice
AU  - Preslaski C
AD  - Department of Surgery, Denver Health Medical Center, 777 Bannock St, Denver 
      80204, CO, USA. Electronic address: Candice.Preslaski@dhha.org.
FAU - Burlew, Clay Cothren
AU  - Burlew CC
AD  - Department of Surgery, Denver Health Medical Center, 777 Bannock St, Denver 
      80204, CO, USA. Electronic address: Clay.Cothren@dhha.org.
FAU - Beyer, Jacob
AU  - Beyer J
AD  - Department of Pharmacy, Denver Health Medical Center, 777 Bannock St, Denver 
      80204, CO, USA. Electronic address: Jacob.Beyer@dhha.org.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20211015
PL  - United States
TA  - Thromb Res
JT  - Thrombosis research
JID - 0326377
RN  - 9005-49-6 (Heparin)
SB  - IM
CIN - Thromb Res. 2022 Oct;218:199-200. PMID: 34836631
MH  - *Heparin/adverse effects
MH  - Humans
MH  - Partial Thromboplastin Time
OTO - NOTNLM
OT  - Activated partial thromboplastin time
OT  - Antifactor Xa
OT  - Bleeding
OT  - Mortality
OT  - Thrombosis
OT  - Unfractionated heparin
EDAT- 2021/10/23 06:00
MHDA- 2021/12/24 06:00
CRDT- 2021/10/22 20:35
PHST- 2021/08/11 00:00 [received]
PHST- 2021/09/21 00:00 [revised]
PHST- 2021/10/12 00:00 [accepted]
PHST- 2021/10/23 06:00 [pubmed]
PHST- 2021/12/24 06:00 [medline]
PHST- 2021/10/22 20:35 [entrez]
AID - S0049-3848(21)00482-5 [pii]
AID - 10.1016/j.thromres.2021.10.010 [doi]
PST - ppublish
SO  - Thromb Res. 2021 Dec;208:18-25. doi: 10.1016/j.thromres.2021.10.010. Epub 2021 
      Oct 15.