Document Detail


Measurement of patients' bivalirudin plasma levels by a thrombelastograph ecarin clotting time assay: a comparison to a standard activated clotting time.
MedLine Citation:
PMID:  16632802     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Standard activated clotting time (ACT) tests have a poor correlation to bivalirudin levels, leading to uncertainty regarding adequate anticoagulation in percutaneous coronary intervention patients. We tested a Thrombelastograph (TEG) ecarin clotting time (ECT) assay for sensitivity to bivalirudin using blood from 80 patients undergoing interventional cardiology procedures with bivalirudin anticoagulation. This was compared to a standard Hemochron ACT assay using diatomaceous earth. With the TEG assay, the direct thrombin activator, ecarin, was used to initiate coagulation and measured as the reaction time. Plasma samples were evaluated for bivalirudin by a chromogenic assay at an independent hematological laboratory. Linear regression of the standard ACT versus bivalirudin level gave an r = 0.306 whereas the TEG ECT gave a much higher r2 = 0.746 (both P < 0.0001). The TEG ECT should prove more useful than the standard ACT for monitoring bivalirudin anticoagulation across the clinically therapeutic range.
Authors:
Roger C Carroll; Jack J Chavez; Jeffery W Simmons; Carolyn C Snider; Dale C Wortham; Stuart J Bresee; Eli Cohen
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  102     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-04-24     Completed Date:  2006-05-17     Revised Date:  2012-07-11    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1316-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee 37920, USA.
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MeSH Terms
Descriptor/Qualifier:
Blood Coagulation / physiology*
Blood Coagulation Tests / methods
Endopeptidases / diagnostic use*
Hirudins / diagnostic use*
Humans
Linear Models
Peptide Fragments / diagnostic use*
Recombinant Proteins / diagnostic use
Thrombelastography / methods*
Whole Blood Coagulation Time / methods
Chemical
Reg. No./Substance:
0/Hirudins; 0/Peptide Fragments; 0/Recombinant Proteins; 128270-60-0/bivalirudin; EC 3.4.-/Endopeptidases; EC 3.4.24.-/ecarin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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