PMID- 38343640
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240213
IS  - 2296-858X (Print)
IS  - 2296-858X (Electronic)
IS  - 2296-858X (Linking)
VI  - 11
DP  - 2024
TI  - Pilot study examining anti-factor Xa levels for heparin monitoring and outcomes 
      in patients with cerebral venous thrombosis.
PG  - 1317246
LID - 10.3389/fmed.2024.1317246 [doi]
LID - 1317246
AB  - OBJECTIVE: There are no studies to date that examine the association between 
      anti-factor-Xa (AFXa)-based heparin monitoring and clinical outcomes in the 
      setting of cerebral venous thrombosis (CVT). METHODS: This pilot study included 
      adults aged >/=18 admitted with CVT between 1 January 2018 and 1 January 2021, who 
      were treated with unfractionated heparin (UFH) and were monitored via AFXa-based 
      nomogram within 24 h of arrival. Comparisons were made between patients with AFXa 
      levels within the target therapeutic range (0.25-0.5 IU/mL) and patients whose 
      levels were not within the therapeutic range within 24 h of arrival; the time 
      (hours) from arrival to reach the therapeutic range was also examined. Outcomes 
      were length of stay (LOS) in the hospital, major (actionable) bleeding events, 
      and discharge home (vs. higher acuity location). Continuous data are reported in 
      the form of the median (interquartile range). RESULTS: Among 45 patients, 
      treatment with UFH was initiated 2 (1-11) h after arrival, and the majority (84%) 
      of UFH infusions did not need dose adjustment. AFXa assays were conducted every 6 
      (5.5-7) h. Thirty patients (67%) fell within the therapeutic range. Outcomes were 
      similar for patients with levels within the therapeutic range vs. not: major 
      bleeding events, 10% vs. 0% (p = 0.54); discharge home, 77% vs. 80% (p = 1.0); 
      LOS, 5 days in each group (p = 0.95). There was also no association between 
      outcomes and time to reach the therapeutic range. CONCLUSION: Our findings 
      demonstrate the practicability of monitoring UFH based on AFXa values in this 
      population of patients with CVT, but reaching target AFXa levels within 24 h of 
      arrival may not necessarily be prognostic.
CI  - Copyright (c) 2024 Pirahanchi, Salottolo, Burrell, Tang, Bar-Or and Bartt.
FAU - Pirahanchi, Yasaman
AU  - Pirahanchi Y
AD  - Neurology Department, Swedish Medical Center, Englewood, CO, United States.
FAU - Salottolo, Kristin
AU  - Salottolo K
AD  - Trauma Research Department, Swedish Medical Center, Englewood, CO, United States.
FAU - Burrell, Christian
AU  - Burrell C
AD  - Neurology Department, Swedish Medical Center, Englewood, CO, United States.
FAU - Tang, Xu
AU  - Tang X
AD  - Neurology Department, Swedish Medical Center, Englewood, CO, United States.
FAU - Bar-Or, David
AU  - Bar-Or D
AD  - Trauma Research Department, Swedish Medical Center, Englewood, CO, United States.
FAU - Bartt, Russell
AU  - Bartt R
AD  - Neurology Department, Swedish Medical Center, Englewood, CO, United States.
LA  - eng
PT  - Journal Article
DEP - 20240126
PL  - Switzerland
TA  - Front Med (Lausanne)
JT  - Frontiers in medicine
JID - 101648047
PMC - PMC10858448
OTO - NOTNLM
OT  - anti-factor-Xa
OT  - cerebral venous thrombosis
OT  - monitoring
OT  - outcomes
OT  - unfractionated heparin
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2024/02/12 15:42
MHDA- 2024/02/12 15:43
PMCR- 2024/01/26
CRDT- 2024/02/12 04:08
PHST- 2023/10/17 00:00 [received]
PHST- 2024/01/08 00:00 [accepted]
PHST- 2024/02/12 15:43 [medline]
PHST- 2024/02/12 15:42 [pubmed]
PHST- 2024/02/12 04:08 [entrez]
PHST- 2024/01/26 00:00 [pmc-release]
AID - 10.3389/fmed.2024.1317246 [doi]
PST - epublish
SO  - Front Med (Lausanne). 2024 Jan 26;11:1317246. doi: 10.3389/fmed.2024.1317246. 
      eCollection 2024.