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Related Experiment Videos

Monitoring anticoagulation following intracoronary procedures: which method?

M J Brack1, R S More, L N Forbat

  • 1Academic Department of Cardiology, Glenfield General Hospital, Leicester, UK.

International Journal of Cardiology
|June 15, 1994
PubMed
Summary

Bedside activated partial thromboplastin time (aPTT) kits accurately monitor heparin anticoagulation during percutaneous coronary interventions. While effective for routine use, prothrombin fragment F1+2 levels offer tighter control when needed.

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Area of Science:

  • Cardiology
  • Hematology
  • Clinical Chemistry

Background:

  • Effective anticoagulation management is crucial during percutaneous coronary interventions (PCI).
  • Accurate monitoring of heparin therapy is essential to prevent thrombotic and bleeding complications.
  • Bedside testing offers potential advantages in rapid assessment of anticoagulation status.

Purpose of the Study:

  • To evaluate the accuracy of bedside activated partial thromboplastin time (aPTT) kits compared to laboratory values.
  • To assess the reliability of bedside aPTT for monitoring heparin anticoagulation.
  • To compare bedside aPTT with activated clotting time (ACT) and correlate with heparin and prothrombin fragment F1+2 levels.

Main Methods:

  • Prospective study involving 14 patients undergoing elective PCI.

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  • Serial blood samples collected pre-procedure, post-heparin bolus, and at 1, 2, and 3 hours after heparin infusion.
  • Comparison of bedside aPTT results with laboratory aPTT, ACT, plasma heparin concentrations, and prothrombin fragment F1+2 levels.

    • Main Results:

    • Bedside aPTT results showed good correlation with laboratory aPTT values (r = 0.8).
    • Bedside aPTT provided rapid results and reflected appropriate changes in heparin and prothrombin fragment F1+2 levels.
    • The correlation between bedside aPTT and ACT was less precise (r = 0.59).

    Conclusions:

    • Bedside aPTT kits are suitable for routine monitoring of heparin anticoagulation during PCI.
    • For situations requiring very precise anticoagulation control, prothrombin fragment F1+2 measurements may be more appropriate.
    • Bedside aPTT offers a reliable and rapid method for assessing heparin therapy in interventional cardiology settings.