Measurement of patients' bivalirudin plasma levels by a Thrombelastograph® ecarin clotting time assay: A comparison to a standard activated clotting time

Roger C. Carroll, Jack Chavez, Jeffery W. Simmons, Carolyn C. Snider, Dale Wortham, Stuart Bresee, Eli Cohen

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Standard activated clotting time (ACT) tests have a poor correlation to bivalirudin levels, leading to uncertainty regarding adequate anticoagulation in percutaneous coronary intervention patients. We tested a Thrombelastograph® (TEG®) ecarin clotting time (ECT) assay for sensitivity to bivalirudin using blood from 80 patients undergoing interventional cardiology procedures with bivalirudin anticoagulation. This was compared to a standard Hemochron ACT assay using diatomaceous earth. With the TEG® assay, the direct thrombin activator, ecarin, was used to initiate coagulation and measured as the reaction time. Plasma samples were evaluated for bivalirudin by a chromogenic assay at an independent hematological laboratory. Linear regression of the standard ACT versus bivalirudin level gave an r2 = 0.306 whereas the TEG® ECT gave a much higher r2 = 0.746 (both P < 0.0001). The TEG® ECT should prove more useful than the standard ACT for monitoring bivalirudin anticoagulation across the clinically therapeutic range.

Original languageEnglish (US)
Pages (from-to)1316-1319
Number of pages4
JournalAnesthesia and Analgesia
Volume102
Issue number5
DOIs
StatePublished - Jan 1 2006

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Diatomaceous Earth
Percutaneous Coronary Intervention
ecarin
bivalirudin
Cardiology
Thrombin
Uncertainty
Linear Models
Therapeutics

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

Measurement of patients' bivalirudin plasma levels by a Thrombelastograph® ecarin clotting time assay : A comparison to a standard activated clotting time. / Carroll, Roger C.; Chavez, Jack; Simmons, Jeffery W.; Snider, Carolyn C.; Wortham, Dale; Bresee, Stuart; Cohen, Eli.

In: Anesthesia and Analgesia, Vol. 102, No. 5, 01.01.2006, p. 1316-1319.

Research output: Contribution to journalArticle

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