Laboratory determination of old and new targeted anticoagulant agents for prevention of bleeding and thrombotic events in cancer patients
Research article published in Thrombosis research (2016)
Abstract
A two-fold prolongation of activated partial thromboplastin time (APTT) is established as therapeutic range for therapy with unfractionated heparin, hirudin and argatroban. The international normalized ratio (INR) of 2 to 3 is required to maintain anticoagulation in the therapeutic range of vitamin K antagonists. The therapeutic range of anti-factor Xa activity during therapy with low-molecular weight heparins and danaparoid are less well and of direct oral anticoagulants (DOAC) poorly defined. The relation of aPTT and INR values to thrombotic and bleeding events are well established despite a large variation of values in affected patients. The relation of coagulation values of the other anticoagulants to clinical events is open. The value of determination in cancer patients is higher because of the increased risk for thrombotic and bleeding events of this patient group. Several activities are currently undertaken to certify methods for in vitro diagnostic testing for DAOCs.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
A two-fold prolongation of activated partial thromboplastin time (APTT) is established as therapeutic range for therapy with unfractionated heparin, hirudin and argatroban.
Why This Matters for Hirudotherapy
This article discusses laboratory monitoring of anticoagulant therapy in cancer patients, noting that a two-fold prolongation of activated partial thromboplastin time (APTT) is the established therapeutic range for unfractionated heparin, hirudin, and argatroban. Hirudin is mentioned only in passing as one of several anticoagulants whose therapeutic range is defined by APTT, alongside discussion of less well-defined monitoring for newer oral anticoagulants. For ASH's domain, this brief mention confirms that hirudin—the prototypical leech-derived anticoagulant—requires laboratory monitoring in clinical use. However, the article provides no original data, no hirudin-specific findings, and no detail beyond the one-line mention; hirudin is not the focus, and the article's emphasis is on newer anticoagulants in oncology.
Citation
Laboratory determination of old and new targeted anticoagulant agents for prevention of bleeding and thrombotic events in cancer patients
Harenberg J · Thrombosis research, 2016
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