The effect of oral anticoagulant therapy on aptt results from a bedside coagulation monitor |
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Authors: | M J Ray P A Carroll S J E Just G A T Hawson J H N Belt |
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Institution: | (1) Department of Pathology, The Prince Charles Hospital, Brisbane, Queensland, Australia;(2) Department of Cardiology, The Prince Charles Hospital, Brisbane, Queensland, Australia;(3) Pathology Department, The Prince Charles Hospital, Rode Rd, Chermside, 4032 Queensland, Australia |
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Abstract: | Objective. The Ciba Corning 512 coagulation monitor (CC512) can be used to monitor heparin therapy by performing an activated
partial thromboplastin time (APTT) at the patient’s bedside. This study was designed to compare the CC512 results to results
using the laboratory system. The relative sensitivities of both systems to the effect of oral anticoagulant therapy also was
investigated.Methods. Activated partial thromboplastin times were performed with both the CC512 and laboratory system on 74 specimens from patients
receiving IV heparin therapy, and on 14 specimens from patients on warfarin only. Heparin assays were performed on 43 of the
specimens from the heparinized patients.Results. When a patient was receiving heparin only, the APTT results of the CC512 proved to be similar to existing laboratory methods.
The CC512 APTT results of patients on warfarin only were markedly prolonged, whereas the laboratory APTTs were only slightly
affected.Conclusion. The CC512 results were comparable to the laboratory system. However, the CC512 APTT was more sensitive to the effect of
warfarin than the laboratory APTT system used in this study. CC512 APTT results on a patient receiving both oral and intravenous
anticoagulation could be misleading.
The authors wish to thank D.M. O’Brien and the nursing staff of the Coronary Care Unit for providing CC512 data and laboratory
specimens, and I. Smith for the preparation of graphics. We also wish to thank Australian Diagnostics Corporation, which provided
consumables. |
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Keywords: | Blood: coagulation Anticoagulants: heparin warfarin |
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