PMID- 37189590
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230519
IS  - 2075-4418 (Print)
IS  - 2075-4418 (Electronic)
IS  - 2075-4418 (Linking)
VI  - 13
IP  - 8
DP  - 2023 Apr 20
TI  - Laboratory Assessment of Unfractionated Heparin (UFH) with Activated Clotting 
      Time (ACT) and Anti-Xa Activity during Peripheral Arterial Angiographic 
      Procedure.
LID - 10.3390/diagnostics13081489 [doi]
LID - 1489
AB  - Activated clotting time (ACT) is used in cardiac surgery for monitoring 
      unfractionated heparin (UFH). In endovascular radiology, ACT use is less 
      established. We aimed to test the validity of ACT in UFH monitoring in 
      endovascular radiology. We recruited 15 patients undergoing endovascular 
      radiologic procedure. ACT was measured with ICT Hemochron((R)) device as 
      point-of-care (1) before standard UFH bolus, (2) immediately after the bolus, and 
      in some cases (3) 1 h into the procedure or a combination thereof (altogether 32 
      measurements). A total of two different cuvettes, ACT-LR and ACT+ were tested. A 
      reference method of chromogenic anti-Xa was used. Blood count, APTT, thrombin 
      time and antithrombin activity were also measured. UFH levels (anti-Xa) varied 
      between 0.3-2.1 IU/mL (median 0.8) and correlated with ACT-LR moderately (R(2) = 
      0.73). The corresponding ACT-LR values were 146-337 s (median 214). ACT-LR and 
      ACT+ measurements correlated only modestly with one another at this lower UFH 
      level, with ACT-LR being more sensitive. Thrombin time and APTT were unmeasurably 
      high after the UFH dose, rendering them of limited use in this indication. We 
      adopted an ACT target of >200-250 s in endovascular radiology based on this 
      study. While ACT correlation with anti-Xa is suboptimal, the readily available 
      point-of-care nature increases its suitability.
FAU - Helin, Tuukka
AU  - Helin T
AUID- ORCID: 0000-0002-5273-8088
AD  - Department of Clinical Chemistry, HUS Diagnostic Center, Helsinki University 
      Hospital, P.O. Box 720, 00029 Helsinki, Finland.
AD  - Department of Clinical Chemistry, University of Helsinki, 00014 Helsinki, 
      Finland.
FAU - Tirri, Tomi
AU  - Tirri T
AD  - Department of Clinical Chemistry, HUS Diagnostic Center, Helsinki University 
      Hospital, P.O. Box 720, 00029 Helsinki, Finland.
AD  - Department of Clinical Chemistry, University of Helsinki, 00014 Helsinki, 
      Finland.
FAU - Korkala, Heidi
AU  - Korkala H
AD  - Department of Radiology, HUS Diagnostic Center, Helsinki University Hospital, 
      P.O. Box 320, 00029 Helsinki, Finland.
FAU - Lappalainen, Kimmo
AU  - Lappalainen K
AD  - Department of Radiology, HUS Diagnostic Center, Helsinki University Hospital, 
      P.O. Box 320, 00029 Helsinki, Finland.
FAU - Joutsi-Korhonen, Lotta
AU  - Joutsi-Korhonen L
AUID- ORCID: 0000-0002-7355-2354
AD  - Department of Clinical Chemistry, HUS Diagnostic Center, Helsinki University 
      Hospital, P.O. Box 720, 00029 Helsinki, Finland.
AD  - Department of Clinical Chemistry, University of Helsinki, 00014 Helsinki, 
      Finland.
LA  - eng
PT  - Journal Article
DEP - 20230420
PL  - Switzerland
TA  - Diagnostics (Basel)
JT  - Diagnostics (Basel, Switzerland)
JID - 101658402
PMC - PMC10137659
OTO - NOTNLM
OT  - activated clotting time
OT  - anti-Xa
OT  - endovascular
OT  - interventional radiology
OT  - unfractionated heparin
COIS- The authors declare no conflict of interest.
EDAT- 2023/05/16 06:42
MHDA- 2023/05/16 06:43
PMCR- 2023/04/20
CRDT- 2023/05/16 01:10
PHST- 2022/12/28 00:00 [received]
PHST- 2023/04/13 00:00 [revised]
PHST- 2023/04/13 00:00 [accepted]
PHST- 2023/05/16 06:43 [medline]
PHST- 2023/05/16 06:42 [pubmed]
PHST- 2023/05/16 01:10 [entrez]
PHST- 2023/04/20 00:00 [pmc-release]
AID - diagnostics13081489 [pii]
AID - diagnostics-13-01489 [pii]
AID - 10.3390/diagnostics13081489 [doi]
PST - epublish
SO  - Diagnostics (Basel). 2023 Apr 20;13(8):1489. doi: 10.3390/diagnostics13081489.