Anticoagulant Therapy

Reprise: Validating POC INRs

Back to our April 24 anticoagulation clinic manager’s question about when to validate a prolonged point of care (POC) prothrombin time with international normalized ratio (PT/INR). George spoke with representatives of Roche Diagnostics, distributor ofCoag-U-Chek instruments, while attending the May 3–5 Thrombosis and Hemostasis Summit of North America meeting in Chicago. While Roche contends this is a local decision and […]

Anticoagulant Therapy

Poll: How Many Monitor “Dabi” With ECT?

Good afternoon George! Are there any labs out there using the ecarin clotting time to test for dabigatran level? We know it doesn’t “need” to be monitored, but we also realize that there will be practitioners looking for such information. I have trialed the ECA-T kit from Diagnostica Stago with Aniara calibrators/controls. Thanks! Crystal Azevedo. Hi, […]

Anticoagulant Therapy

Hemolysis and Heparin Anti-Xa

A message from “Danagah:” Hi, George, How would you handle a sample for a chromogenic heparin anti-Xa assay if a patient is experiencing in vivo hemolysis and you cannot obtain a sample that is not hemolyzed? Would it make a difference as to the degree of hemolysis as to even accepting the sample? We reject […]

Anticoagulant Therapy

ASCLS-Missouri Meeting April 17-19

The Missouri branch of the American Society for Clinical Laboratory Science holds its annual state meeting at the Millennium Hotel in St. Louis, April 17-19, 2012. George provides a presentation on Thursday, April 19, “Monitoring the New Anticoagulants, Whatever Happened to the PT and PTT?” from 1 to 2:30. Attached below is the PowerPoint handout. […]

Anticoagulant Therapy

Dabigatran Clearance

Another post from Bob Gosselin (we hit the mother lode today!): GF: Re dabigatran clearing in 24 hours: This is not necessarily so, depending on the patient, as we have seen “dabi” levels (q12 drug) with trough before next dose of ~150ng/mL. So I would highly suggest using thrombin times for assessing the clearing of drug, as […]

Anticoagulant Therapy

POC INRs

From Bob Gosselin: Hey GF, re point of care (POC) international normalized ratios (INRs), assuming that you are collecting a citrated sample for testing, a high hematocrit (HCT) should not matter for a system that employs fingerstick whole blood, since there is no citrate:plasma ratio issue at hand with using whole blood. Viscosity may be an issue […]

Anticoagulant Therapy

ACC

Here is a summary of the just-ended American College of Cardiology meeting in Chicago. It appears there was a lot of attention given to the new oral anticoagulants, especially to dabigatran (Pradaxa), which has been available since 2010 in the US. I’ve been seeing lawyer’s ads on TV recently, 1-800-BAD-DRUG, focusing on Pradaxa. Does Pradaxa deserve this […]

Anticoagulant Therapy

Monitoring Dabigatran with the ACT

George, We are a large public tertiary care hospital in West Tennessee. I am in the special coag lab. We are encountering some problems with patients coming in on dabigatran who need invasive stent procedures. Typically when the cardiologist uses heparin during the catheterization he orders an activated clotting time (ACT) post-procedure looking for a […]

Anticoagulant Therapy

How Many Use the Anti-Xa?

Hi George, I have visited your site a few times in the past and I own your pocket guide book, so I thought of you when I came up with this question. I read in ASCLS Today an article about monitoring heparin therapy using the chromogenic anti Xa assay instead of APTT. Is that standard […]

Anticoagulant Therapy

Anti-Xa Assay With LA Present?

Dear George, I have a lupus anticoagulant (LA) positive patient with recurrent pregnancy loss. She is on low molecular weight heparin (LMWH) with a request for an anti-Xa assay. Will LA positive whether it is interference by LMWH? What is your opinion? Hello, Vilas, the chromogenic anti-Xa heparin assay provides an accurate measure of unfractionated […]

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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