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MEASUREMENT OF ACTIVATED PARTIAL THROMBOPLASTIN TIME CAN VARY ACCORDING TO REAGENTS IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION TAKING DABIGATRAN
A352 JACC March 17, 2015 Volume 65, Issue 10S
Arrhythmias and Clinical EP Measurement of Activated Partial Thromboplastin Time Can Vary According to Reagents in Patients with Non-Valvular Atrial Fibrillation Taking Dabigatran Poster Contributions Poster Hall B1 Saturday, March 14, 2015, 3:45 p.m.-4:30 p.m. Session Title: Anticoagulation for Atrial Fibrillation: How Are We Doing? Abstract Category: 4. Arrhythmias and Clinical EP: AF/SVT Presentation Number: 1148-252 Authors: Hirokazu Kondo, Yoshihisa Nakagawa, Chisato Izumi, Kazuaki Kaitani, Toshihiro Tamura, Soichiro Enomoto, Makoto Miyake, Yodo Tamaki, Tenri Hospital Cardiovascular Medicine, Tenri City, Japan
Background: Activated partial thromboplastin time (aPTT) provides a qualitative assessment of anticoagulant activity in patients receiving dabigatran. While coagulation monitoring is not required with dabigatran in routine clinical practice, it is reported that serious bleeding occurred in patients with aPTT level in trough over 80 seconds. It is important to measure aPTT level in patients receiving dabigatran in clinical practice. It has been reported that measurement of aPTT can vary according to reagents. So we need to give attention to differences in aPTT levels between laboratories. Methods: From 149 outpatients with non-valvular atrial fibrillation under dabigatran therapy, aPTT was measured with five different reagents (A: COAGPIAAPTT-N®, Sekisui Medical and B: THROMBOCHECK APTT-SLA®, Sysmex Corporation, C: THROMBOCHECK APTT®, Sysmex Corporation, D: ACTIN FSL®, Sysmex Corporation, E: Deta-fi APTT®, Sysmex Corporation), and aPTT ratio was calculated. APTT ratio was defined the value of aPTT divided by the average of aPTT in thirty healthy volunteers.
Results: The aPTT measured with five reagents were 46.8±;9.8 sec (A), 38.7±;6.7 sec (B), 41.9±;8.7 sec (C), 43.5±;8.2 sec (D), and 42.4±;8.7 sec (E) and the aPTT ratio were 1.47±;0.31 sec (A), 1.32±;0.23 sec (B), 1.38±;0.29 sec, (C), 1.37±;0.26 sec (D), and 1.42±;0.29 sec (E). In both aPTT and aPTT ratio, the difference among five reagents was statistically significant. The number of specimen whose aPTT was over 80 sec was only one with C and aPTT ratio was over 2.0 was 9 with A, 0 with B, 3 with C, 5 with D, 8 with E.
Conclusion: With five different reagents, aPTT level varied and the number of excess anticoagulant activity differed among five reagents. We should interpret high aPTT values with caution in patients taking dabigatran.
Arrhythmias and Clinical EP Measurement of Activated Partial Thromboplastin Time Can Vary According to Reagents in Patients with Non-Valvular Atrial Fibrillation Taking Dabigatran Poster Contributions Poster Hall B1 Saturday, March 14, 2015, 3:45 p.m.-4:30 p.m. Session Title: Anticoagulation for Atrial Fibrillation: How Are We Doing? Abstract Category: 4. Arrhythmias and Clinical EP: AF/SVT Presentation Number: 1148-252 Authors: Hirokazu Kondo, Yoshihisa Nakagawa, Chisato Izumi, Kazuaki Kaitani, Toshihiro Tamura, Soichiro Enomoto, Makoto Miyake, Yodo Tamaki, Tenri Hospital Cardiovascular Medicine, Tenri City, Japan
Background: Activated partial thromboplastin time (aPTT) provides a qualitative assessment of anticoagulant activity in patients receiving dabigatran. While coagulation monitoring is not required with dabigatran in routine clinical practice, it is reported that serious bleeding occurred in patients with aPTT level in trough over 80 seconds. It is important to measure aPTT level in patients receiving dabigatran in clinical practice. It has been reported that measurement of aPTT can vary according to reagents. So we need to give attention to differences in aPTT levels between laboratories. Methods: From 149 outpatients with non-valvular atrial fibrillation under dabigatran therapy, aPTT was measured with five different reagents (A: COAGPIAAPTT-N®, Sekisui Medical and B: THROMBOCHECK APTT-SLA®, Sysmex Corporation, C: THROMBOCHECK APTT®, Sysmex Corporation, D: ACTIN FSL®, Sysmex Corporation, E: Deta-fi APTT®, Sysmex Corporation), and aPTT ratio was calculated. APTT ratio was defined the value of aPTT divided by the average of aPTT in thirty healthy volunteers.
Results: The aPTT measured with five reagents were 46.8±;9.8 sec (A), 38.7±;6.7 sec (B), 41.9±;8.7 sec (C), 43.5±;8.2 sec (D), and 42.4±;8.7 sec (E) and the aPTT ratio were 1.47±;0.31 sec (A), 1.32±;0.23 sec (B), 1.38±;0.29 sec, (C), 1.37±;0.26 sec (D), and 1.42±;0.29 sec (E). In both aPTT and aPTT ratio, the difference among five reagents was statistically significant. The number of specimen whose aPTT was over 80 sec was only one with C and aPTT ratio was over 2.0 was 9 with A, 0 with B, 3 with C, 5 with D, 8 with E.
Conclusion: With five different reagents, aPTT level varied and the number of excess anticoagulant activity differed among five reagents. We should interpret high aPTT values with caution in patients taking dabigatran.