COMPARISON OF BEDSIDE AND HOSPITAL LABORATORY COAGULATION STUDIES DURING AND AFTER CORONARY INTERVENTION

The activated clotting time is routinely used to monitor anticoagulati on during coronary intervention, whereas the hospital laboratory APTT guides pre- and postprocedure heparin therapy, An optimal coagulation test far patients undergoing percutaneous revascularization would prov ide a rapid and accurate assessment of anticoagulation throughout a br oad range of heparin therapy, We studied the relationships of the beds ide whole blood APTT, ACT, and the laboratory APTT in 166 patients und ergoing coronary intervation. The whole blood APTT correlated closely with the laboratory APTT (range 18-80 sec) (r = .75), whereas the ACT and laboratory APTT had only a fair correlation(r = .42). Also, the wh ole blood APTT demonstrated a strong correlation with the ACT througho ut the range of heparin therapy for intervention (r = .81), The diagno stic accuracy of the whole blood APTT, based on the receiver operating characteristic curve, was significantly better than that for the ACT in determining the anticoagulation status. The whole blood APTT obtain ed by bedside monitoring provides a rapid and accurate assessment of a nticoagulation throughout the range of heparin dosing associated with coronary intervention, In situations in which an adequate assessment o f residual anticoagulation is necessary, the whole blood APTT is super ior to the ACT and probably should be the method of choice. (C) 1995 W iley-Liss, Inc.