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Standardization of the activated partial thromboplastin time for monitoring of heparin therapy: Where should we go?

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  • 2nd International Symposium On Standardization And Quality Control Of Coagulation Tests: Implications For The Clinical Laboratory
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Research in Clinic and Laboratory

Summary

Standardization of the APTT for monitoring of heparin therapy is needed urgently. On the one hand, reference materials and methods should be established. On the other hand, the scale for reporting of results should be standardized. The implementation of a system based on a reference APTT method meets a number of practical problems. The use of lyophilized plasma as a reference material is of questionable value, until these products more satisfactorily resemble fresh patient plasma specimens.

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References

  1. Bain B., Forster T., Sleigh B.: Heparin and the activated partial thromboplastin time. A difference betweenin-vitro andin-vivo effects and implications for the therapeutic range — Amer. J. Clin. Pathol.74, 668, 1980.

    CAS  Google Scholar 

  2. Barrowcliffe T. W., Mulloy B., Johnson E. A., Thomas D. P.: The anticoagulant activity of heparin: measurement and relationship to chemical structure — J. pharmaceut. Biomed.7, 217, 1989.

    Article  CAS  Google Scholar 

  3. Basu D., Gallus A., Hirsh J., Cade J.: A prospective study of the value of monitoring heparin treatment with the activated partial thromboplastin time — New Engl. J. Med.287, 324, 1972.

    PubMed  CAS  Google Scholar 

  4. Fennerty A., Campbell I. A.: Anticoagulants in venous thromboembolism. Guidelines for optimum treatment — Brit. med. J.297, 1285, 1988.

    Article  PubMed  CAS  Google Scholar 

  5. Gawoski J. M., Arkin C. F., Bovill T., Brandt J., Rock W. A., Triplett D. A.: The effects of heparin on the activated partial thromboplastin time of the College of American Pathologists survey specimens — Arch. Pathol. Lab. Med.111, 785, 1987.

    PubMed  CAS  Google Scholar 

  6. Holm H. A., Abildgaard U., Larsen M. L., Kalvenes S.: Monitoring of heparin therapy: should heparin assays also reflect the patients’ antithrombin concentration? — Thrombos. Res.46, 669, 1987.

    Article  CAS  Google Scholar 

  7. Hull R. D., Raskob G. E., Hirsh J., Jay R. M., Leclerc J. R., Geerts W. H., Rosenbloom D., Sackett D. L., Anderson C., Harrison L., Gent M.: Continuous intravenous heparin compared with intermittent subcutaneous heparin in the initial treatment of proximal-vein thrombosis — New Engl. J. Med.315, 1109, 1986.

    PubMed  CAS  Google Scholar 

  8. Juhan-Vague I., Riera H., Aillaud M. F., Verdet D., Sambuc R.: Measurement of blood heparin levels — variation in results with assay method — Thrombos. Haemostas.47, 295, 1982.

    CAS  Google Scholar 

  9. Kelton J. G., Hirsh J.: Bleeding associated with antithrombotic therapy — Semin. Hematol.17, 259, 1980.

    PubMed  CAS  Google Scholar 

  10. Koepke J. A.: Partial thromboplastin time test: proposed performance guidelines — Thrombos. Haemostas.55, 143, 1986.

    CAS  Google Scholar 

  11. Loeliger E. A., Broekmans A. W.: Optimal therapeutic anticoagulation — Haemostasis15, 283, 1985.

    PubMed  CAS  Google Scholar 

  12. Marder V. J.: A simple technique for the measurement of plasma heparin concentration during anticoagulant therapy — Thrombos. Diathes. haemorrh. (Stuttg.)24, 230, 1970.

    CAS  Google Scholar 

  13. Schuler J., Von Felten A.: Eine einfache Methode zur Kontrolle der Antikoagulation mit Vitamin-K-Antagonisten unter Heparintherapie: Quick-Bestimmung nach Absorption des Heparins mittels ECTEOLA-Cellulose — Schweiz. med. Wschr.112, 1798, 1982.

    PubMed  CAS  Google Scholar 

  14. Schulman S., Granqvist S., Wiman B., Lockner D.: Thrombolysis and fibrinolytic parameters during heparin treatment of deep vein thrombosis — Thrombos. Res.39, 607, 1985.

    Article  CAS  Google Scholar 

  15. Scialla S. J.: Heparin monitoring by activated partial thromboplastin time. Comparison ofex vivo measurement andin vitro standardization — Amer. J. clin. Pathol.84, 351, 1985.

    CAS  Google Scholar 

  16. Thomson J. M.: The control of heparin therapy by the activated partial thromboplastin time: results of collaborative studies — Scand. J. Haematol.25 (Suppl. 37), 73, 1980.

    Google Scholar 

  17. van den Besselaar A. M. H. P., Bertina R. M.: Relationships between different laboratory methods for monitoring of heparin therapy — Thrombos. Haemostas.62, 510, 1989.

    Google Scholar 

  18. van Putten J., van de Ruit M., Beunis M., Hemker H. C.: Automated spectrophotometric heparin assays. Comparison of methods — Haemostasis14, 195, 1984.

    PubMed  Google Scholar 

  19. Walker M. G., Shaw J. W., Thomson G. J. L., Cumming J. G. R., Thomas M. L.: Subcutaneous calcium heparin versus intravenous sodium heparin in treatment of established acute deep vein thrombosis of the legs: a multicentre prospective randomised trial — Brit. med. J.294, 1189, 1987.

    CAS  Google Scholar 

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van den Besselaar, A.M.H.P. Standardization of the activated partial thromboplastin time for monitoring of heparin therapy: Where should we go?. Res. Clin. Lab. 19, 371–377 (1989). https://doi.org/10.1007/BF02871828

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