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

More on ISTAT Versus PT/INr

Here is a Paul Riley, PhD follow up to Diane Treadway’s discussion and follow-up comment comparing the ISTAT INR to the central lab plasma-based PT/INR. From Dr. Riley, Stago-US. I don’t understand what is happening with the bivalirudin interference. According to Gosselin et al. (below) there should be minimal effect on the Stago PT (see […]

Anticoagulant Therapy

Collect Specimens After Dialysis

Here is a question from colleague, friend, and frequent contributor Larry Brace, PhD, Edward Hospital, Naperville, IL: Our (years-old) phlebotomy policy says to wait 4 hours after dialysis before venipuncture unless a doctor approves the draw. It makes sense but we can’t seem to find a reference. Can you suggest any? Also, is this policy pretty […]

Anticoagulant Therapy

Ottawa Blood Disease Center DOAC Survey

George is posting this survey invitation as a courtesy to the Ottawa Blood Disease center and encourages all physician Fritsma Factor participants to join the survey: Hello, You are being asked to participate in a research survey* that we have developed. Physician members from a variety of associations in Canada, the United States and Europe […]

Anticoagulant Therapy

Whole Blood PTs

From: Brancaccio Mauro, ICD-Partners, Italy. Is it possible and correct to do the PT on the sangueblood? Hello, Bancaccio Mauro. If I translate correctly, I will take sangueblood to mean whole blood (with thanks to Dave McGlasson for his assistance). Yes, the PT has been established as a whole blood assay using point of care […]

Anticoagulant Therapy

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George Fritsma is a medical laboratory scientist, educator, and author. George is a member of the International Society on Thrombosis and Hemostasis, the International Society for Laboratory Hematology, and the American Society for Clinical Laboratory Science.

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