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

[img] Text
s-0035-1570035.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (161kB) | Request a copy

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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology

UniBE Contributor:

Schindewolf, Marc

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0171-6425

Publisher:

Thieme

Language:

English

Submitter:

Catherine Gut

Date Deposited:

08 Jun 2016 12:45

Last Modified:

17 Sep 2016 01:30

Publisher DOI:

10.1055/s-0035-1570035

PubMed ID:

26757210

BORIS DOI:

10.7892/boris.81100

URI:

https://boris.unibe.ch/id/eprint/81100

Actions (login required)

Edit item Edit item
Provide Feedback