Aug 1 2022

george

July 2022 QQ: Reduced concentration RIPA test.responses

Our July 2022 Quick Question asked, “What VWD subtype is identified using the reduced concentration RIPA test?” We received 30 votes. Here are our answers: VWD Type 1: 10% [3] VWD Type 1C: 0 VWD Subtype 2A: 3% VWD Subtype 2B: 87% VWD Subtype 2M: 0 VWD Subtype 2N: 0 VWD Type 3: 0 Few […]

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Bleeding Disorders

Jun 30 2022

george

July 2022 QQ: Reduced concentration RIPA test.

Our July 2022 Quick Question asks, “What von Willebrand disease [VWD] subtype is identified using the reduced concentration ristocetin-induced platelet aggregometry [RIPA] test?” Many of the VWD types and subtypes are currently identified using molecular diagnosis, however, the “legacy” phenotypic tests often provide a speedy and inexpensive shortcut. This may be one such case. Please […]

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Bleeding Disorders

Jun 30 2022

george

June, 2022 Quick Question Summary: VET Instruments

Our June 2022 Quick Question asked, “What viscoelastometry [VET] equipment is employed in your ER or OR?” Out total response was 22 participants. Answers: Thromboelastograph 5000 [TEG]: 18% [4] Thromboelastograph 6S [TEG]: 18% [4] Thromboelastometry [ROTEM]: 23% [5] Quantra Qplus: 0 Sienco Sonoclot: 0 Our lab doesn’t manage VET testing: 41% [9] At the June […]

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Global Hemostasis Assays

Jun 1 2022

george

May 2022 QQ: Thrombosis Risk Profile Summary

We had near-100% agreement on our May 2022 Quick Question, which attracted 45 voters: “What assay should be deleted from the thrombosis risk factor profile?” Here are our selections: Protein C 0% Protein S 2% [1] Antithrombin 2% [1] Activated protein C resistance 7% [3] Prothrombin G20210A mutation 4% [2] Methylenetetrahydrofolate reductase resistance [MTHFR] polymorphism […]

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Quick Question Archive

Apr 30 2022

george

May 2022 QQ: Thrombosis Risk Profile

Our May 2022 Quick Question asks, “What assay should be deleted from the thrombosis risk factor profile?” Thrombosis risk testing has been available to us since von Kaulla first described “antithrombin 3” deficiency in 1972 using the “serum antithrombin” test. It gained momentum when Dahlbach described activated protein C resistance in 1994, and thrombosis risk […]

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Quick Question Archive

Apr 30 2022

george

April 2022 QQ: Measuring Heparin Summary

Hello, our April 2022 Quick Question asks, “How do you measure unfractionated heparin [UFH]?” Our 37 respondents answered… Chromogenic anti-Xa using a hybrid curve: 38% [14] Chromogenic anti-Xa using the UFH curve: 14% [5] Anti-Xa and PTT: 22% [8] PTT: 26% [9] The majority of respondents are using the chromogenic anti-Xa heparin assay, and most […]

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Anticoagulant Therapy

Mar 31 2022

george

April 2022 QQ: Measuring Heparin

Our April 2022 Quick Question reprises our May 16, 2012 post, “Who Uses the Hybrid Curve?” but adds a twist based on May JE, Siniard RD, Taylor LJ, Marques MB, Gangaraju R. From activated partial thromboplastin time to anti-factor Xa and back again; the evolution of monitoring unfractionated heparin. Am J Clin Pathol 2022;157:321–7 HTTPS://DOI.ORG/10.1093/AJCP/AQAB135. […]

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Anticoagulant Therapy

Mar 31 2022

george

March 2022 Quick Question Summary

The stem of our March 2022 Quick Question was, “How do you measure the anti-Xa DOACs rivaroxaban or apixaban?” The question drew 33 responses and here are the answer selections: We don’t measure the anti-Xa DOACs: 24% [8] Chromogenic anti-Xa using DOAC-specific calibrators and controls: 64% [21] Chromogenic anti-Xa using the unfractionated heparin curve: 3% […]

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Anticoagulant Therapy

Mar 1 2022

george

March 2022 Quick Question: Measuring Anti-Xa DOACs

Please review and answer our March 2022 Quick Question, submitted by colleague and coagulation expert Dave McGlasson. Although the US FDA has never approved the chromogenic anti-Xa assay for the direct oral anticoagulants rivaroxaban and apixaban, calibrators and controls are available from several distributors. Many facilities are called upon to assay for plasma concentration in […]

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Anticoagulant Therapy

Mar 1 2022

george

February, 2022 QQ Response: Platelet Aggs

Thanks to our 57 FF participants for your responses to our February 2022 Quick Question. The question stem was: “What single agonist is your first choice to measure platelet response to aspirin?” ADP: 14% [8] TRAP: 2% [1] Collagen: 2% [1] Epinephrine: 28% [16] Arachidonic acid: 54% [31] Although this question is a poll, my […]

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Arterial Thrombosis