Anticoagulant Therapy

Anti-Xa Result is Zero

From Jennifer Watson, Centracare Health: Hello, What are your recommendations when an anti factor Xa returns with a value of 0, even after increasing doses several times? Thank you. Hello, Jennifer, and thank you for this question. Assuming the heparin dosing has been administered correctly, you may be seeing a patient who has acquired, or […]

Anticoagulant Therapy

Monitoring UFH With In Vivo Hemolysis

From Andrew Goodwin, MD, University of Vermont: Hey George, I am wondering if you have experience with in-vivo hemolysis following AnigioJet mechanical pharmacothrombectomy using TPA. We had two patients over the past week in which in-vivo hemolysis was moderate to severe. In our first patient, the hemolysis was not immediate; it appeared about 12 hours […]

Anticoagulant Therapy

Anticoagulation Webinar 1-27-16

The International Society on Thrombosis and Haemostasis presents an ISTH Academy Webinar: Monitoring of Anticoagulation reaturing Adam Cuker, MD, and Gualtiero Palareti, MD, Wednesday, January 27, 15–1600 UTC. The webinar is free to ISTH members.

Anticoagulant Therapy

FDA Public Workshop on POC PT/INR

The US Food and Drug administraion will offer a public workshop, “Point of Care Prothrombin Time/International Normalized Ratio Devices for Monitoring Warfarin Therapy,” March 18, 2016 at their White Oak Campus, 10903 New Hampshire Avenue, Silver Spring, MD.

Anticoagulant Therapy

FDA Public Workshop on DOACs

The US Food and Drug Administration has released the full transcript and video recordings of their October 26, 2015 all day public workshop, “In Vitro Diagnostic Testing for Direct Oral Anticoagulants.” The workshop features Frederick Korley, Adam Cuker, Dorothy Adcock-Funk, Robert Gosselin, Stephan Moll, and several FDA representatives. Here is the transcript: /sites/default/files/doac_testing_fda_transcript_10-26-15.pdf

Anticoagulant Therapy

Switching From Rivaroxaban to Heparin

We’ve widely acknowledged that the anti-Xa assay, currently employed to monitor heparin therapy, may be readily adapted to measuring direct oral anti-Xa antthrombotics, and at least three hemostasis diagnostics manufacturers have developed and validated rivaroxaban and apixaban calibrators and controls for this purpose. These await US FDA clearance. Meanwhile, we estimate oral anti-Xa antithrombotic efficacy […]

Anticoagulant Therapy

Kcentra Reversal of DOAC Overdose

From Gabor Varadi, MD, Albert Einstein Cancer Center, Philadelphia. I would like to ask you about Kcentra dosing for non-coumadin related indications. This would be for treating life threatening bleeding or urgent reversal prior to surgery for patients receiving targeted anticoagulants. This would only apply to the direct oral Xa antagonists, not dabigatran. Do you think […]

Anticoagulant Therapy

When to Start with Protein C and S Antigen Assay

Kristi Williams, a participant in George’s online Michigan State University (go Sparties!) graduate Hemostasis course, iasked this excellent question: I suspect practitioners in our area don’t necessarily always know or understand when the protein C and S activity vs. antigen tests should be ordered. It’s clear that protein C and S activity level assays are […]

Anticoagulant Therapy

Effect of HCT on POC INR

George received this question from the ASCLS Consumer Web Forum via Bonnie Jo Taylor, MHS, MT(ASCP)SH. I have hemochromatosis, too much iron in my blood. I’ve also had blood clots in my lungs. I peroidically undergo phlebotomy treatments to lower iron count. Will this alter the results of my INR finger prick test results? Here […]

Anticoagulant Therapy

Dabigatran Safety and Efficacy in Women

Here is an October 28, 2015 Heartwire article describing differences in dabigatran safety and efficacy between women and men.

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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