Monitoring Heparin Therapy

Letters15 January 1994Monitoring Heparin TherapyPatrick Brill-Edwards, MD, Jeffrey S. , MD, and Jack Hirsh, MDPatrick Brill-Edwards, MDMcMaster University Medical Centre; Hamilton, Ontario LSN 375; CanadaHamilton Civic Hospitals Research Centre; Hamilton, Ontario LSN 1C3; CanadaSearch for more papers by this author, Jeffrey S. , MDMcMaster University Medical Centre; Hamilton, Ontario LSN 375; CanadaHamilton Civic Hospitals Research Centre; Hamilton, Ontario LSN 1C3; CanadaSearch for more papers by this author, and Jack Hirsh, MDMcMaster University Medical Centre; Hamilton, Ontario LSN 375; CanadaHamilton Civic Hospitals Research Centre; Hamilton, Ontario LSN 1C3; CanadaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-2-199401150-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:The results of our study show that the variation in the responsiveness of the aPT reagents to heparin is problematic. We presented one method to compensate for the lack of standardization of aPT reagents.Drs. Raschke and Reilly agree that a need exists to improve the common target of 1.5 to 2.5 times the control value. The method they propose would be reasonable if the responsiveness of different lots of the reagent did not change significantly over time; however, we have shown significant lot-to-lot variation using the same reagent. Further, the use of different laboratory instruments may alter ...References1. Shojania AM, Tetreault J, Turnbull G. The variations between heparin sensitivity of different lots of activated partial thromboplastin time reagent produced by the same manufacturer. Am J Clin Pathol. 1988; 89:19-23. Google Scholar2. Hull RD, Raskob GE, Rosenbloom D, Panju A, Brill-Edwards P, Ginsberg JS, et al. Heparin for 5 days as compared with 10 days in the initial treatment of proximal venous thrombosis. N Engl J Med. 1990; 322:1260-4. Google Scholar3. Turpie AG, Robinson JG, Doyle DJ, Mulju AS, Mishkel GJ, Sealey BJ, et al. Comparison of high dose with low dose subcutaneous heparin to prevent left ventricular mural thrombosis in patients with acute transmural anterior myocardial infarction. N Engl J Med. 1989; 320:352-7. Google Scholar4. Zanke B, Shojania AM. Comparison of two aPT methods of monitoring heparin therapy. Am J Clin Pathol. 1990; 93:684-9. Google Scholar5. Johnston M, Moffat K, Ginsberg J, Hirsh J, Brill-Edwards P. A simplified procedure for the establishment of APT therapeutic ranges for heparin (HEP) therapy. Thromb Haemost. 1993; 69:652. Google Scholar Author, Article, and Disclosure InformationAffiliations: McMaster University Medical Centre; Hamilton, Ontario LSN 375; CanadaHamilton Civic Hospitals Research Centre; Hamilton, Ontario LSN 1C3; Canada PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 January 1994Volume 120, Issue 2Page: 169-170KeywordsBlood plasmaChartsClinical trialsHeparinProtaminesResearch laboratoriesSystematic reviewsThromboembolism ePublished: 15 August 2000 Issue Published: 15 January 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...