Premium
Correlation between activated partial thromboplastin time and anti‐Xa activity in patients who received low‐molecular weight heparin as anticoagulation for haemodialysis
Author(s) -
Wong Steve SiuMan,
Lau WaiYan,
Chan PingKwan,
Wan ChingKit,
Cheng YukLun
Publication year - 2017
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13122
Subject(s) - medicine , partial thromboplastin time , low molecular weight heparin , heparin , anticoagulant , anesthesia , coagulation
ABSTRACT Plasma anti‐Xa activity, the recommended test to monitor low‐molecular weight heparin (LMWH) therapy, is not readily available in many laboratories. In our clinical trials on the use of LMWH as anticoagulation for haemodialysis, a consistent prolongation of APTT in addition to the elevated anti‐Xa activity was observed in the patients after LMWH administration. Hence, the paired anti‐Xa activity and APTT data were re‐analyzed. The APTT ratio, which was the proportional change in APTT from the baseline value after LMWH administration, was found to have a strong correlation with anti‐Xa activity (coefficient of determination, R 2 = 0.72, P < 0.001). In the receiver operating characteristic analysis, the APTT ratio was also found to be an excellent predictor of therapeutic anti‐Xa activity ≧0.5 IU/mL (area under curve = 0.93, P < 0.001). The sensitivity was 88% and the specificity was 83.3% when an APTT ratio ≧1.4 was used as the cut point to predict the achievement of therapeutic anti‐Xa activity. Our results illustrated that APTT is a potentially useful screening test to assess the degree of anticoagulation achieved by LMWH during haemodialysis, if the testing for plasma anti‐Xa activity is not available.