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World Thrombosis Day

Join me in commemorating World Thrombosis Day.

New DOAC Reversal Agents

George, I noticed on Fritsma Factor the question on using Kcentra to reverse DOACs.  I just got this off Medscape on a phase 3 study of an antidote to the  factor Xa inhibitor apixaban. An IV bolus of andexanet alfa immediately and significantly reversed apixaban in 33 healthy volunteers enrolled in the ANNEXA-A study.  The authors also state that Idarucizumab reverses the oral thrombin inhibitor dabagatran etexilate mesylate.  Both have FDA breakthrough status.
Regards,
David L. McGlasson, GS-13
Clinical Research Scientist

KCentra to Reverse DOACs?

From Gabor Varadi, Einstein Healthcare:
Hello George, I would like to ask your opinion about using 4-component prothrombin complex concentrate (PCC) for rivaroxaban and dabigatran-induced life-threatening bleeding. Any scientific data to support using this product? Thank you.

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Quick Question: Platelet Function Poll

From Scott Miller at St. Mary’s of Michigan: Just a note. We use both the PFA-100 and the Verify Now for platelet function testing. I am unable to get the poll to accept more than one response. Scott

Thank you, Scott, we will add your response to the total when we publish the results. Geo

TEG and ROTEM: Reprise

We have two valuable posts on the December 3, 2013 topic of Thromboelastograph (TEG) versus the Rotational Thromboelastometer (ROTEM), asking about transporting platelet function testing specimens through the tube system. I just want to ensure you didn’t miss this useful information.

QQ Results: Overfilled Coag Tubes

From our summer, 2014 Quick Question, What is your policy for managing overfilled coagulation specimen tubes?

a. We reject overfilled tubes; results are likely to be invalid. 116 votes, 69%
b. We accept overfilled tubes; overfilling doesn’t affect results. 28 votes, 17%
c. We never see overfilled tubes. 24 votes, 14%

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Cepheid Factor II and V Mutations

From Dr. Joyce Low, St. Vincent’s Hospital, Sydney. We were wondering if anyone has had experience of the Cepheid combine factor V Leiden mutation and prothrombin G20210A (Xpert factor II and V) assay on the GeneXpert which was FDA-cleared in 2006.

Thank you, Dr. Low, I’ve had no experience, but hope to hear from our participants.

Pediatric INR?

From Patti Richardson, St. Christopher’s Hospital for Children:

Good afternoon, George: For critical values, are pediatric hospitals using the prothrombin time and international normalized ratio (PT & INR)? For pediatric hospitals, what is the INR critical value most often used?

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