PMID- 35438827
OWN - NLM
STAT- MEDLINE
DCOM- 20220720
LR  - 20220720
IS  - 1751-553X (Electronic)
IS  - 1751-5521 (Linking)
VI  - 44
IP  - 4
DP  - 2022 Aug
TI  - Monitoring of heparin therapy beyond the anti-Xa activity assay: Evaluation of a 
      thrombin generation assay.
PG  - 785-795
LID - 10.1111/ijlh.13836 [doi]
AB  - INTRODUCTION: Global coagulation assays may be of added value to the anti-Xa 
      assay for monitoring heparin therapy. Unlike most testing methods, the thrombin 
      generation assay (TGA) has the ability to assess the overall function of the 
      hemostatic system, which provides information on the anticoagulation status of 
      patients. We compared the TGA, measured with ST Genesia((R)) STG-DrugScreen((R)) 
      reagent, with the anti-Xa assay for monitoring heparin therapy in inflammatory 
      and non-inflammatory patients. We also determined reference values for 
      STG-DrugScreen((R)) thrombin generation (TG) parameters. METHODS: Reference values 
      were determined on 120 healthy donors. Furthermore, a spiking experiment with 
      unfractionated heparin (UFH) and low molecular weight heparin (LMWH) was 
      performed, and samples of patients receiving UFH or LMWH were analyzed with ST 
      Genesia((R)) and the anti-Xa assay. RESULTS: High discrepancy between TG parameters 
      and anti-Xa activity was observed for low LMWH anti-Xa levels. TG parameters were 
      affected in 36/46 (time to peak) to 42/46 (peak height) patients during UFH 
      therapy with sub-target anti-Xa activity levels. CONCLUSION: TGA seems 
      insufficiently sensitive for low concentrations of LMWH. There may be an added 
      value of the TGA for monitoring UFH in so-called heparin-resistant patients. 
      Therefore, the TGA has the potential to be introduced as an additional tool for 
      monitoring heparin therapy.
CI  - (c) 2022 John Wiley & Sons Ltd.
FAU - Vermeiren, Pauline
AU  - Vermeiren P
AD  - Coagulation Laboratory, Department of Laboratory Medicine, Ghent University 
      Hospital, Ghent, Belgium.
FAU - Vandevelde, Arne
AU  - Vandevelde A
AUID- ORCID: 0000-0002-0461-7476
AD  - Coagulation Laboratory, Department of Laboratory Medicine, Ghent University 
      Hospital, Ghent, Belgium.
AD  - Department of Diagnostic Sciences, Ghent University, Ghent, Belgium.
FAU - Peperstraete, Harlinde
AU  - Peperstraete H
AD  - Department of Intensive Care Medicine, Ghent University Hospital, Belgium.
FAU - Devreese, Katrien M J
AU  - Devreese KMJ
AUID- ORCID: 0000-0002-7559-2579
AD  - Coagulation Laboratory, Department of Laboratory Medicine, Ghent University 
      Hospital, Ghent, Belgium.
AD  - Department of Diagnostic Sciences, Ghent University, Ghent, Belgium.
LA  - eng
PT  - Journal Article
DEP - 20220419
PL  - England
TA  - Int J Lab Hematol
JT  - International journal of laboratory hematology
JID - 101300213
RN  - 0 (Anticoagulants)
RN  - 0 (Factor Xa Inhibitors)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.21.5 (Thrombin)
SB  - IM
MH  - Anticoagulants/pharmacology/therapeutic use
MH  - Blood Coagulation Tests
MH  - Factor Xa Inhibitors/pharmacology/therapeutic use
MH  - *Heparin/adverse effects
MH  - *Heparin, Low-Molecular-Weight/pharmacology/therapeutic use
MH  - Humans
MH  - Thrombin
OTO - NOTNLM
OT  - blood coagulation tests
OT  - heparin
OT  - reference values
OT  - thrombin
EDAT- 2022/04/20 06:00
MHDA- 2022/07/22 06:00
CRDT- 2022/04/19 12:39
PHST- 2022/02/24 00:00 [revised]
PHST- 2021/11/27 00:00 [received]
PHST- 2022/03/15 00:00 [accepted]
PHST- 2022/04/20 06:00 [pubmed]
PHST- 2022/07/22 06:00 [medline]
PHST- 2022/04/19 12:39 [entrez]
AID - 10.1111/ijlh.13836 [doi]
PST - ppublish
SO  - Int J Lab Hematol. 2022 Aug;44(4):785-795. doi: 10.1111/ijlh.13836. Epub 2022 Apr 
      19.