Anticoagulant Therapy

Does the “Buzzy” Affect the INR?

This is from George’s friend and colleague, Dennis Ernst, of the Center for Phlebotomy Education: A good friend of mine is a pediatric emergency physician, needle-pain expert, and entrepreneur. Dr. Amy Baxter has developed a device you may have already heard of. It’s called the Buzzy. (She was my newsletter’s Mover & Shaker in March.) […]

Anticoagulant Therapy

More on Xarelto and D-dimer

Dr. Jeanine Walenga, Clinical Coagulation Laboratory Director at Loyola University Medical Center added a helpful comment to our April 13, 2016 discussion about Xarelto and D-dimer. Click here to see the discussion and her comment.

Anticoagulant Therapy

Switching From Rivaroxaban to Heparin

Amy Kelley, Dahl Chase Diagnostic Services, asks, one of our hospitals had a patient on Xarelto who came in for surgery. This hospital uses STAGO Xa testing which uses a hybrid curve. The patient’s Xa should drop after 3 days. The patient was put on unfractionated heparin (UFH) while in the hospital. Our question: Should […]

Anticoagulant Therapy

PT and INR Means

Wendy Sutula at Medstar asks about the PT reference interval calculation. Hi, George. Each time we convert to a new lot of PT reagent we run normals and calculate a geometric mean (geomean) to be used in the INR calculation. My question is this. When we are validating or re-validating the PT normal range, is […]

Anticoagulant Therapy

Xarelto and D-dimer

George and Dr. Louann Lawrence have been communicating with a patient through the ASCLS Consumer Web Forum who experienced a DVT and PE in 2014 and has been on Xarelto since then. Her physician routinely orders a D-dimer to assess the risk of a recurrence after discontinuing Xarelto. The patient stops Xarelto for 24 hours […]

Anticoagulant Therapy

Bivalirudin and Ecarin Clotting Time

Maria Grana asks, who uses the ecarin clotting test? Can the ecarin clotting test be used for bivalirudin (Angiomax) monitoring? Is the ecarin clotting test FDA approved? We are having complaints from MDs that the activated clotting time (ACT) is not responding to administration of heparin on some patients. Can these patients have antithrombin (AT, […]

Anticoagulant Therapy

ACT Cuvettes

From Lesa Nelson, who was a graduate student in George’s fall, 2015 Michigan State University Hemostasis and Thrombosis and Resource Management online graduate course. Our cardiac catheterization laboratory performed an ACT using the Hemochron ACT+ cuvette, designed to measure the effects of 1–6 U/mL (high dose) heparin. They were getting ACT results of 149–190 seconds […]

Anticoagulant Therapy

Repeat SRA Testing

From Julia: Hi George, Our physicians order repeat serotonin release assay (SRA) testing on the same patients during the same hospitalization after heparin therapy has been stopped. Sometimes the physicians order within hours. We have called and asked if they are duplicates and they insist they need this testing. Is there research or literature to […]

Anticoagulant Therapy

Rocket AF Controversy

It appears the often-criticized Rocket AF clinical trial, the results of which the FDA used to approve rivaroxaban (Xarelto), may have been flawed by the use of the Alere INRatio2 PT/INR point of care device in its Coumadin arm, recalled by the FDA in January of 2015. Read more in Medscape.

Anticoagulant Therapy

Clinical VTE Guidance

The Anticoagulation Forum has published a special issue of the Journal of Thrombosis and Thrombolysis, Volume 41; Management of Venous Thromboembolism: Clinical Guidance from the Anticoagulation Forum. The issue, consisting of 12 articles, is free online. The Forum also offers a free noon, EST March 3 webinar, Guidance for the Prevention and Treatment of Cancer-Associated […]

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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