Antifactor Xa Activity for the Management of Anticoagulation during Cardiac Surgery

Reyher, Christian; Würfel, Claire; Lindhoff-Last, Edelgard; Meybohm, Patrick; Zacharowski, Kai; Moritz, Anton; Schindewolf, Marc; Weber, Christian Friedrich (2016). Antifactor Xa Activity for the Management of Anticoagulation during Cardiac Surgery. Thoracic and cardiovascular surgeon, 64(06), pp. 494-500. Thieme 10.1055/s-0035-1570035

Text s-0035-1570035.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (161kB)

Background In patients with autoimmune diseases associated with antiphospholipid antibodies, precise management of anticoagulation during extracorporeal circulation (ECC) is complicated. It was the aim of the present study to determine whether antifactor Xa (aXa) activity is useful in guiding heparin therapy during ECC. Methods In 15 patients undergoing cardiac surgery, anticoagulation with unfractionated heparin (UFH) and its reversal with protamine were guided using activated clotting time (ACT) (>400 second during ECC; ≤100 second for UFH reversal). For each ACT, the corresponding aXa activity levels were measured. Results A total of 144 blood samples were obtained. ACT and aXa activity were significantly correlated (r = 0.771, p< 0.0001, Spearman rank-order correlation). Using receiver operating characteristic curve (ROC) analyses, the cutoffvalues for aXa activity were 1.14 IU/mL (area under the ROC curve [AUC]: 0.89; inaccuracy rate: 9.4%) to predict ACT > 400 seconds and 0.55 IU/mL (AUC: 0.85; inaccuracy rate: 13.3%) for ACT ≤ 100 seconds. Conclusion AXa activity is strongly correlated with ACT, and therefore may be feasible for managing anticoagulation with UFH during ECC.

Interest & Impact

Downloads

0 since deposited on 08 Jun 2016
0 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item