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Activated partial thromboplastin time: new tricks for an old dogma.

Giuseppe Lippi¹, Emmanuel J Favaloro

¹Sezione di Chimica Clinica, Università di Verona, Verona, Italy. giuseppe.lippi@univr.it

Seminars in Thrombosis and Hemostasis

|December 17, 2008

Summary

Shortened activated partial thromboplastin time (APTT) indicates hypercoagulability, significantly increasing venous thromboembolism risk. This finding offers renewed utility for the traditional APTT test in assessing thrombotic risk.

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Area of Science:

Hematology
Clinical Pathology
Coagulation Diagnostics

Background:

Activated partial thromboplastin time (APTT) is a routine coagulation test.
Traditionally used for intrinsic pathway abnormalities, heparin monitoring, and inhibitor detection (e.g., lupus anticoagulant).
Shortened APTT values were previously overlooked but are now linked to hypercoagulability.

Purpose of the Study:

To investigate the clinical relevance of shortened APTT values.
To explore the association between shortened APTT and venous thromboembolism (VTE) risk.
To highlight emerging utilities of APTT, including waveform analysis.

Main Methods:

Retrospective analysis of routine laboratory APTT results.
Association studies correlating APTT values with VTE events.
Evaluation of APTT waveform analysis in specific clinical contexts.

Main Results:

Shortened APTT is significantly associated with a major risk of VTE, independent of other risk factors.
APTT waveform analysis shows promise in diagnosing sepsis, disseminated intravascular coagulation, and identifying antiphospholipid antibodies.
Emerging evidence suggests novel applications for APTT beyond traditional uses.

Conclusions:

Shortened APTT may serve as a valuable indicator of hypercoagulability and VTE risk.
APTT, including its waveform analysis, offers expanding diagnostic and prognostic utility in various clinical settings.
The APTT test demonstrates renewed importance in modern laboratory diagnostics.