February 1, 1991American Journal of Clinical Pathology
Measurement of the Activated Partial Thromboplastin Time from a Capillary (fingerstick) Sample of Whole Blood: A New Method for Monitoring Heparin Therapy
Why the study?
Does aPTT measurement from a fingerstick sample of capillary whole blood using a portable monitor correlate with standard venipuncture-derived plasma aPTTs in subjects on heparin and/or warfarin?
Population
319 subjects including normal controls and individuals on heparin and/or warfarin
Comparison
aPTT measurement using the Ciba Corning… vs Venipuncture-derived standard laboratory plasma…
Design
Cross-sectional
Authors
Discussion
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Implication
Fingerstick aPTT correlates comparably to inter-reagent lab variation; supports feasibility but leaves open clinical adoption pending prospective validation.
Key Points
- To assess the diagnostic accuracy and precision of a portable bedside monitor measuring activated partial thromboplastin time from capillary whole blood samples.
- Evaluated 319 subjects, comprising normal controls and patients treated with heparin, warfarin, or both anticoagulants.
- Compared fingerstick capillary whole blood aPTT values against standard laboratory plasma aPTT tests across multiple reagents, as well as venipuncture-derived whole blood on the portable monitor.
- Fingerstick aPTT values correlated with standard laboratory plasma aPTTs with correlation coefficients ranging from 0.79 to 0.83, matching the correlation between different standard laboratory reagents (r = 0.79).
- Correlation between fingerstick and venipuncture whole blood samples analyzed on the portable device was r = 0.93.
- Analytical precision evaluations in healthy controls demonstrated low coefficients of variation for both within-day and between-day measurements.
Structured PICO
Does aPTT measurement from a fingerstick sample of capillary whole blood using a portable monitor correlate with standard venipuncture-derived plasma aPTTs in subjects on heparin and/or warfarin?
P
Population
319 subjects including normal controls and individuals on heparin and/or warfarin
I
Intervention
aPTT measurement using the Ciba Corning Diagnostics 512 Coagulation Monitor from a fingerstick sample of capillary whole blood
C
Comparator
Venipuncture-derived standard laboratory plasma aPTTs using different aPTT reagents on conventional instruments
O
Outcome
Correlation between fingerstick and standard aPTTssurrogate
A hand-held portable instrument measuring aPTT from a fingerstick sample of capillary whole blood correlates well with standard laboratory plasma aPTTs, offering a reliable bedside monitoring method for heparin therapy.
Cite This Study
Ansell et al. (1991) studied this question.