[Use of heparin calibrated anti-Xa assay for apixaban and rivaroxaban measurement in the context of regional telestroke activity].

IF 0.4 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY
Céline Delassasseigne, Clémentine Leroux, Pauline Renou, David Girard, Anne Lafargue, Stéphane Morel, Pierre Thomas Belotti, Laurent Weinmann
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引用次数: 0

Abstract

Introduction: In Bordeaux University Hospital, neurologists are required to prescribe thrombolysis using telemedicine (telethrombolysis) for anticoagulated stroke patients admitted in peripheral centers in the Nouvelle-Aquitaine region. However, due to the bleeding risk, the maximum concentration of DOAC authorizing thrombolysis is 30, 50 or 100 ng/mL (depending on the sources and the patient-specific benefit-risk ratio). Most of the time, specific assays of Direct Oral Anticoagulants (DOACs) are not available in these peripheral centers. We therefore studied an alternative test: the Unfractionated Heparin (UFH) anti-Xa activity which is available in most laboratories and could be used to estimate the DOAC concentration.

Methods: Five centers were included in our study: three centers using the Liquid Anti-Xa HemosIL® Werfen reagent and two centers using the STA-Liquid Anti-Xa® Stago reagent. For each reagent, we established correlation curves between DOAC and UFH anti-Xa activities and determinated UFH cut-offs for the thresholds of 30, 50 and 100 ng/mL respectively.

Results: A total of 1455 plasmas were tested. There is an excellent correlation between DOAC and UFH anti-Xa activities using a third-degree modeling curve, independently the reagent used. However, a significant inter-reagent variability is observed concerning the obtained cut-offs.

Conclusion: Our study makes unsuitable the use of a universal cut-off. In opposition to recommendations made by other publications, the UFH cut-offs must be adapted to the reagent used locally by the laboratory, and to the considered DOAC.

[使用肝素校准抗xa测定阿哌沙班和利伐沙班在区域卒中活动的背景下测量]。
简介:在波尔多大学医院,神经内科医生被要求对新阿基坦地区周边中心收治的抗凝脑卒中患者使用远程医疗(远程溶栓)进行溶栓。然而,由于出血风险,DOAC允许溶栓的最大浓度为30、50或100 ng/mL(取决于来源和患者特异性获益-风险比)。大多数时候,直接口服抗凝剂(DOACs)的特异性检测在这些外周中心是不可用的。因此,我们研究了一种替代测试:未分级肝素(UFH)抗xa活性,这是在大多数实验室可用的,可用于估计DOAC浓度。方法:我们的研究包括5个中心:3个中心使用Liquid Anti-Xa haemsil®Werfen试剂,2个中心使用STA-Liquid Anti-Xa®Stago试剂。对于每种试剂,我们建立了DOAC与UFH抗xa活性的相关曲线,并分别测定了阈值为30、50和100 ng/mL的UFH截止值。结果:共检测了1455个等离子体。使用三度建模曲线,DOAC和UFH抗xa活性之间具有良好的相关性,与使用的试剂无关。然而,对于得到的截止值,观察到显著的试剂间变异性。结论:本研究不适合采用通用截止。与其他出版物提出的建议相反,UFH截止值必须适应实验室在当地使用的试剂和所考虑的DOAC。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annales de biologie clinique
Annales de biologie clinique 医学-医学:研究与实验
CiteScore
0.80
自引率
20.00%
发文量
53
审稿时长
6-12 weeks
期刊介绍: Multidisciplinary information with direct relevance to everyday practice Annales de Biologie Clinique, the official journal of the French Society of Clinical Biology (SFBC), supports biologists in areas including continuing education, laboratory accreditation and technique validation. With original articles, abstracts and accounts of everyday practice, the journal provides details of advances in knowledge, techniques and equipment, as well as a forum for discussion open to the entire community.
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