Bedside Blood Test Found to Detect Anticoagulation Status

Hemonox clotting time test helps identify patients poorly anticoagulated before PCI
By Jeff Muise
HealthDay Reporter

WEDNESDAY, Feb. 10 (HealthDay News) -- A new bedside blood test can be used to determine the sufficiency of anticoagulation in patients who are about to undergo catheterization or percutaneous coronary intervention (PCI), according to a study in the Feb. 16 issue of the Journal of the American College of Cardiology.

Johanne Silvain, M.D., of the Université Paris, and colleagues assessed 296 patients undergoing catheterization and/or PCI who had received injected enoxaparin anticoagulation medication previously (elective) or received it intravenously just prior to the procedure (urgent). The researchers measured whole blood Hemonox clotting time (CT) using the microcoagulation bedside assay Hemochron Jr. Hemonox, and also preformed an activated partial thromboplastin time test, both at bedside. Blood samples were tested later to determine anti-Xa activity level. The tests were compared to determine the ability of the Hemonox CT test to determine anticoagulation status.

The researchers found that the anticoagulation procedure failed to produce optimal anticoagulation in just 5.2 percent of patients, as evidenced by inadequate anti-Xa levels. Using a 120 s threshold, the Hemonox CT bedside test identified subjects with inadequate anticoagulation with a high sensitivity (94.9 percent) and good specificity (73.3 percent). It had a negative predictive value of 94.78 percent and a positive predictive value of 73.9 percent.

"Hemonox CT appears to be a fast and reliable bedside test for detecting patients insufficiently anticoagulated and needing adjustment of anticoagulation therapy with enoxaparin before PCI," the authors write.

This study was supported in part by International Technidyne Corporation, which manufactures the Hemochron Jr. Hemonox assay used in the study. Several study authors reported financial relationships with multiple pharmaceutical or medical device companies.

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