Monitoring heparin therapy: stability of two different anti-Xa assays using blood samples collected in citrate-containing and CTAD tubes

Thrombosis Journal

Research

Marion Gremillet¹  Laurie Talon¹  Thomas Sinegre¹  Aurélien Lebreton² 

[1] CHU Clermont-Ferrand, Service d’hématologie Biologique, 1 Place Lucie Et Raymond Aubrac, 63003, Clermont-Ferrand, France;CHU Clermont-Ferrand, Service d’hématologie Biologique, 1 Place Lucie Et Raymond Aubrac, 63003, Clermont-Ferrand, France;Université Clermont Auvergne, Unité de Nutrition Humaine, UMR INRAE/UCA 1019, Clermont-Ferrand, France;

关键词: Blood coagulation tests;    Drug monitoring;    Heparin;    Haemostasis;    Pre-analytical phase;   

DOI  :  10.1186/s12959-023-00465-8

 received in 2022-09-21, accepted in 2023-02-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAnti-factor Xa assays and activated partial thromboplastin time (aPTT) are mainly employed to monitor patients treated with heparins. According to the Clinical and Laboratory Standards Institute and the French Working Group on Haemostasis and Thrombosis, anti-factor Xa activity and aPTT should be tested within 2 h of blood sampling for unfractionated heparin (UFH) monitoring. However, discrepancies exist depending on the used reagents and collecting tubes. The study aim was to determine the stability of aPTT and anti-factor Xa measurements using blood samples collected in citrate-containing or citrate-theophylline-adenosine-dipyridamole (CTAD) tubes and stored for up to 6 h.MethodsPatients receiving UFH or low molecular weight heparin (LMWH) were enrolled; aPTT and anti-factor Xa activity were tested using two different analyser/reagent pairs (Stago and reagent without dextran sulfate; Siemens and reagent with dextran sulfate) after 1, 4 and 6 h of sample storage as whole blood or as plasma.ResultsFor UFH monitoring, comparable anti-factor Xa activity and aPTT results were obtained with both analyser/reagent pairs when samples were stored as whole blood before plasma isolation. With samples stored as plasma, anti-factor Xa activity and aPTT were not affected up to 6 h after sampling when using the Stago/no-dextran sulfate reagent pair. With the Siemens/dextran sulfate-containing reagent, aPTT was significantly altered after 4 h of storage. For LMWH monitoring, anti-factor Xa activity remained stable (whole blood and plasma) for at least 6 h. Results were comparable with citrate-containing and CTAD tubes.ConclusionsAnti-factor Xa activity in samples stored as whole blood or plasma was stable for up to 6 h, regardless of the reagent (with/without dextran sulfate)/collection tube. Conversely, aPTT was more variable because other plasma parameters can influence its measure and complicate the interpretation of its variations after 4 h.

【 授权许可】

CC BY   
© The Author(s) 2023

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