Thrombosis research
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Thrombosis research · Jan 2008
Comparative StudyDiagnostic accuracy of the Triage D-dimer test for exclusion of venous thromboembolism in outpatients.
We evaluated the diagnostic performance of the Triage D-dimer test, a new fast quantitative point-of-care whole blood D-dimer assay and compared it with the Vidas D-dimer assay. ⋯ The Triage and Vidas D-dimer tests show comparable diagnostic accuracy. Vidas showed a significant higher sensitivity. Our findings strongly suggest lowering the cutoff for the Triage D-dimer test from 400 to 350 ng/mL. In this way specificity lowers from 42 to 38%, but, more importantly, sensitivity increases from 91 to 95%.
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Thrombosis research · Jan 2008
ReviewWarfarin-induced bleeding complications - clinical presentation and therapeutic options.
Acute bleeding during oral anticoagulant therapy is a major challenge in medicine -with millions of patients receiving oral anticoagulant therapy worldwide, the frequency of severe bleeding episodes ranges from 2% to 13%, according to clinical trial data. The major risk associated with the use of oral anticoagulants is haemorrhage, which might be severe or even life-threatening. Treatment decisions for the reversal of oral anti-coagulation (OAC) depend on factors such as urgency of the situation, as determined by the international normalised ratios (INR), location and seventy of bleeding, and indication for anticoagulation. ⋯ In addition, PCC is associated with a more rapid normalisation of the INR and a better clinical outcome due to the balanced ratio of four vitamin-K-dependent clotting factors plus the coagulation inhibitors protein C and Protein S. PCC products containing four factors are the preferred option for the emergency reversal of OAC, according to some clinical treatment guidelines. Other advantages of PCC over FFP include smaller infusion volumes, no blood group testing and virus-inactivated blood product.
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Thrombosis research · Jan 2008
Comparative StudyUsefulness of high-concentration calcium chloride solution for correction of activated partial thromboplastin time (APTT) in patients with high-hematocrit value.
Pseudoprolongation of activated partial thromboplastin time (APTT) is a serious problem in anticoagulation therapy for patients with high hematocrit, such as cyanotic congenital heart diseases. APTT pseudoprolongation occurs when APTT assay is performed using routinely used vacuum sampling tubes containing citrate. Because the plasma fraction is small in high-hematocrit blood, the prescribed volume of citrate would be excessive for APTT assay, resulting in prolongation of clotting or APTT pseudoprolongation. CLSI--The Clinical and Laboratory Standards Institute (formerly NCCLS) method is the established method to correct the pseudoprolongation. However, the CLSI method needs repeated blood drawings and time-consuming, complicate procedures. Thus, alternative simple method is desired. ⋯ High-calcium chloride solution method is useful to correct APTT pseudoprolongation. Because of the simplicity and the need of a single blood drawing, this method would reduce the burdens of not only patients but also clinical laboratory.
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Thrombosis research · Jan 2008
Venous thromboembolism in patients with pancreatic adenocarcinoma: lower incidence in Asian ethnicity.
Pancreatic adenocarcinoma is one of the cancers most frequently associated with venous thromboembolism (VTE), with the varying incidences of 10%-20% reported in Western countries. Asians are known to have a lower risk for VTE than Caucasians, but few studies have been conducted regarding the incidence of VTE in Asian cancer patients. ⋯ The incidence of VTE complications in Korean patients with advanced pancreatic cancer was 5.3%, which is lower than that observed in other ethnic groups. Our study warrants further prospective investigations on the incidence and mechanism of VTE and cerebral infarctions in cancer patients of different ethnic groups.
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This is the first paper reporting a performance verification study of a point-of-care (POC) monitor for prothrombin time (PT) testing according to the requirements given in chapter 8 of the International Organization for Standardization (ISO) 17593:2007 standard "Clinical laboratory testing and in vitro medical devices - Requirements for in vitro monitoring systems for self-testing of oral anticoagulant therapy". The monitor under investigation was the new CoaguChek XS system which is designed for use in patient self testing. Its detection principle is based on the amperometric measurement of the thrombin activity generated by starting the coagulation cascade using a recombinant human thromboplastin. ⋯ The new system demonstrated a high level of trueness and accuracy, and low imprecision in INR testing. It can be concluded that the CoaguChek XS system complies with the requirements in chapter 8 of the ISO standard 17593:2007.