[Study on usefulness of different APTT test kit in variable coagulopathy]

Area of Science:

• Clinical Chemistry
• Hematology
• Diagnostic Assay Development

Background:

• Activated partial thromboplastin time (APTT) tests are crucial for screening intrinsic coagulation pathways.
• Significant variability exists in APTT results across different test kits, complicating clinical interpretation.
• This variability poses challenges in accurately assessing hemostatic activity in patient samples.

Purpose of the Study:

• To evaluate the diagnostic utility of six distinct APTT kits in identifying coagulopathies.
• To compare the performance of APTT kits with varying phospholipids and activators.
• To determine the optimal APTT kit selection based on specific patient disorders, including lupus anticoagulant (LA).

Main Methods:

• Assessed six different APTT test kits with diverse phospholipid and activator compositions.
• Analyzed plasma samples from patients with intrinsic coagulation factor deficiencies, heparin use, von Willebrand disease, LA, and warfarin use.
• Calculated the abnormal APTT detection ratio for each kit across different patient groups.

Main Results:

• All tested APTT kits effectively detected prolonged clotting times in patients with intrinsic coagulation factor deficiencies and those on heparin.
• APTT kits showed lower detection rates for von Willebrand disease, potentially due to mild Factor VIII decreases.
• Kits utilizing synthetic phospholipids demonstrated superior performance in detecting lupus anticoagulant (LA) compared to other kits.

Conclusions:

• The choice of APTT test kit should be tailored to the specific suspected coagulopathy.
• APTT kits employing synthetic phospholipids are highly recommended for detecting LA.
• Synthetic phospholipid-based kits also show promise for identifying coagulopathies in patients with intrinsic factor deficiencies and heparin use.