Anticoagulant Therapy

Hemolysis and Heparin Assay

Frequent contributor Dave McGlasson called from the American Society for Clinical Laboratory Science annual meeting venue in San Diego. He has just heard this question from a colleague. “Can you use the chromogenic anti-Xa heparin assay when the specimen is hemolyzed or icteric?” Her concern arose from cases in which patients had been treated with […]

Anticoagulant Therapy

Betrixaban (Bevyxxa) Approved June 23

The FDA approved Portola’s anti-Xa direct oral anticoagulant Betrixaban as Bevyxxa on June 23, 2017. Click or tap here for the FDA announcement and here for Portola’s press release, indications, and prescribing information. Thanks to Dr. Ali Sadeghi-Khomami of Precision BioLogic for sending along the announcement.

Anticoagulant Therapy

Eliquis Recall due to Mislabeling

Thanks for a heads-up from Dave McGlasson, here is a recall notice from Bristol-Myers Squibb regarding Eliquis tablets whose dosage level was mislabeled.

Anticoagulant Therapy

DOAC Review

Click here for an excellent MedScape review on the DOACs.

Anticoagulant Therapy

Heparin Response Curve

From Maureen Tacke, Idaho; Hi George, my colleagues and I enjoy the Fratsma Factor postings you send. Thank you for the work that you do instilling best practice across the nation. Each year at the PTT lot change, we redo the heparin response curve. We’ve done this to follow practices from years prior. We’ve noted […]

Anticoagulant Therapy

Anticoagulation in Renal Dialysis

A hypothetical case study: a patient whose birthdate was 9-20-1945 had ESRD and non-valvular atrial fibrillation. He had been on renal dialysis since 2011 and had been taking Coumadin since 2005, maintaining an INR of 2.7, even after dialysis was initiated. In the summer of 2014 he experienced a soft-tissue bleed, prompting his nephrologist to […]

Anticoagulant Therapy

Unable to Obtain Dimer Result on Xarelto

From Heather DeVries, Indiana University Health. Hi George! We use the DDHS kit from IL on our TOP series instruments. There is a cancer patient at one of our facilities who has not been able to get a dimer result while on Xarelto. From the error codes, it looks like it would be human anti-mouse […]

Anticoagulant Therapy

Off Label Low Dose DOACs

Click or tap here for Dr. Samual Goldhaber’s video clip describing the prevalence of off-label low dosing of dabigatran, rivaroxaban, and apixaban.

Anticoagulant Therapy

Diluting Chromogenic Anti-Xa’s For Heparin

From Denise Jones: Good afternoon George, A colleague of mine recently questioned why we were diluting our anti-Xa heparins and anti-Xa LMWHs. We do not dilute Arixtra or rivaroxaban. What is standard practice for other labs? We use Stago Liquid Anti-Xa reagent and a hybrid curve. Thank you. Hi, Denise, the specimen dilutions for chromogenic […]

Anticoagulant Therapy

Apixaban After TAVR in AF

A January, 2017 publication indicates that apixaban (Eliquis) yields fewer bleeds, less kidney damage, and fewer strokes in patients with atrial fibrillation after transfemoral aortic valve replacement (TAVR) over the first 30 days of treatment. See Seeger J, Gonska B, Rodewald C, Rottbauer W, Wöhrle J. Apixaban in patients with atrial fibrillation after transfemoral aortic valve replacement (TAVR). JACC: Cardiovascular Interventions 2017;10: DOI: […]

Anticoagulant Therapy

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George Fritsma is a medical laboratory scientist, educator, and author. George holds faculty appointments with Rutgers University and Michigan State University, and is a member of the International Society on Thrombosis and Hemostasis, American Association of Clinical Chemists, and American Society for Clinical Laboratory Science.

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