May 11 2012
On April 29, Crystal Azavedo asked about laboratories that monitor dabigatran with the ecarin clotting time (ECT). Last week at the Thrombosis and Hemostasis Summit of North America I became reacquainted with long-time colleague, Dr. Leon Zuckerman, founder of Coagulation Consultants of Des Plaines, Illinois. Coagulation Consultants is a full-service hemostasis reference laboratory that also offers the ECT. It was good to see Dr. Zuckerman and to be reminded of his laboratory, which has provided reliable service for many years. Geo.
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Anticoagulant Therapy
From Dr. Pruthi, The degree of prolongation of the INR (with
From Dr. Pruthi, The degree of prolongation of the INR (with point of care devices, POC, or venipuncture INRs) varies with the reagent/instrument combination. Since initial case reports (DeRemer CE. Am J Med 2011; Baruch L Ann Pharmacother 2011;45:e40) demonstrating a discrepancy between venipuncture INR and POC INR, van Rynn (Am J Med 2012;125:417) confirmed such a discrepancy in a small 4-volunteer subject study with POC INRs being disproportionately prolonged compared to venipuncture INR. Thus one needs to be cautious in interpreting POC INR in patients on dabigatran.