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Pharmacotherapy. 1999 Jun;19(6):760-6.

Monitoring unfractionated heparin therapy with antifactor Xa activity results in fewer monitoring tests and dosage changes than monitoring with the activated partial thromboplastin time.

Author information

1
Medical Education Department, Abbott Northwestern Hospital, Minneapolis, Minnesota 55407, USA.

Abstract

STUDY OBJECTIVE:

To determine how much more costly it is to monitor unfractionated heparin (UFH) therapy by antifactor Xa heparin activity (HA) than by activated partial thromboplastin time (aPTT).

DESIGN:

Prospective, randomized, unmasked, cohort, single-center study.

SETTING:

A 625-bed, adults-only, private teaching hospital.

PATIENTS:

Two hundred sixty-eight patients with a variety of indications for UFH therapy.

INTERVENTIONS:

Patients were treated with UFH based on ideal weight (75 U/kg bolus, 20 U/kg initial infusion) and monitored by either HA or aPTT, MEASUREMENTS AND MAIN RESULTS: After adjusting for gender, groups were equivalent in patient characteristics and UFH dosage. The HA group had fewer monitoring tests and dosage changes/24 hours than the aPTT group. These reductions neutralized much of the increased cost of the HA assay itself.

CONCLUSION:

Monitoring UFH therapy over 96 hours with an HA assay costs $4.37 more than monitoring with aPTT. This modest increase may be acceptable given other advantages of the HA assay.

PMID:
10391423
DOI:
10.1592/phco.19.9.760.31547
[Indexed for MEDLINE]

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