COLLEGE-OF-AMERICAN-PATHOLOGISTS CONFERENCE XXXI ON LABORATORY MONITORING OF ANTICOAGULANT-THERAPY - THE CLINICAL USE AND LABORATORY MONITORING OF LOW-MOLECULAR-WEIGHT HEPARIN, DANAPAROID, HIRUDIN AND RELATED-COMPOUNDS, AND ARGATROBAN

Objective.-To review the role of the laboratory in monitoring therapy with low-molecular-weight heparin, danaparoid, hirudin, and argatroban , as reflected in the medical literature and the consensus opinion of recognized experts in the field. Data Sources.-Review of the medical l iterature and current clinical practice by a panel of 6 international experts in the field of anticoagulant therapy. Data Extraction and Syn thesis.-The experts made an extensive review of the published literatu re and prepared a draft manuscript, which included preliminary recomme ndations. The draft manuscript was circulated to participants in the C ollege of American Pathologists Conference XXXI on Laboratory Monitori ng of Anticoagulant Therapy prior to the conference. The manuscript an d recommendations were then presented at the Conference for discussion . Recommendations were accepted if a consensus of the 26 experts atten ding the Conference was reached. The results of the discussion were us ed to revise the manuscript into its final form. Conclusions.-This rep ort reviews the mechanism of action and potential uses of these newer anticoagulant agents. General guidelines for monitoring these agents a nd 9 specific recommendations for laboratory monitoring of low-molecul ar-weight heparin and danaparoid are provided, along with citation of the appropriate supporting literature. Issues for which a consensus wa s not reached at the Conference are also discussed.