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April 2022 QQ: Measuring Heparin

Our April 2022 Quick Question reprises our May 16, 2012 post, “Who Uses the Hybrid Curve?” but adds a twist based on May JE, Siniard RD, Taylor LJ, Marques MB, Gangaraju R. From activated partial thromboplastin time to anti-factor Xa and back again; the evolution of monitoring unfractionated heparin. Am J Clin Pathol 2022;157:321–7 HTTPS://DOI.ORG/10.1093/AJCP/AQAB135. Quoting from the article summary…

“An intrainstitutional investigation revealed significant discordance between activated partial thromboplastin time (aPTT) and antifactor Xa (anti-Xa) assays, prompting a transition from the former to the latter in 2013. With the increasing use of oral factor Xa inhibitors (eg, apixaban, rivaroxaban, edoxaban, betrixaban), which interfere with the anti-Xa assay, we adapted our protocol again to incorporate aPTT in patients admitted on oral Xa inhibitors who require transition to UFH.”

Based on our May, 2012 discussion and May’s findings, we ask, “How do you measure unfractionated heparin?” Please answer on the right and add your comments in the comment section below.

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