Key result
Monitoring intravenous unfractionated heparin with anti-factor Xa assays attains therapeutic anticoagulation faster, maintains therapeutic range longer, and demands fewer blood draws than aPTT.
Why the study?
Heparin is commonly monitored using aPTT or anti-Xa assays, but performance and the clinical implications of discordance between these monitoring protocols require assessment in patients receiving intravenous heparin.
Does anti-factor Xa monitoring improve the attainment of therapeutic anticoagulation and reduce discordance compared to aPTT monitoring in patients receiving intravenous unfractionated heparin?
Does anti-factor Xa monitoring improve the attainment of therapeutic anticoagulation and reduce discordance compared to aPTT monitoring in patients receiving intravenous unfractionated heparin?
Anti-factor Xa monitoring for intravenous unfractionated heparin is superior to aPTT monitoring as it achieves therapeutic levels faster, maintains them longer, and is less susceptible to confounding variables.
aPTT–anti-Xa discordance may alter heparin dosing in AF/VTE; leaves open optimal monitoring strategy pending prospective trials.
Heparin, one of the world’s oldest anticoagulation medications, accelerates the rate ofinhibition of previously activated clotting factors. It is most often used in the prophylaxis andtreatment of thromboembolic disorders and complications associated with atrial fibrillation.The two most common ways to monitor plasma heparin levels and anticoagulation therapyare the activated partial thromboplastin time (aPTT) and anti-factor Xa assay (anti-Xa). Thisarticle assesses the performance of aPTT and anti-Xa monitoring protocols and analyzes thediscordance between aPTT and anti-Xa levels and its clinical implications in patients receivingintravenous heparin therapy.
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Opoku et al. (2019) conducted a review in Patients receiving intravenous unfractionated heparin therapy. Anti-factor Xa monitoring vs. aPTT monitoring was evaluated. Monitoring intravenous unfractionated heparin with anti-factor Xa assays attains therapeutic anticoagulation faster, maintains therapeutic range longer, and demands fewer blood draws than aPTT.
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