Do direct thrombin inhibitors affect INR?
Do direct thrombin inhibitors affect INR?
Background: Direct thrombin inhibitors are recommended in confirmed or suspected heparin-induced thrombocytopenia. False elevation of the international normalized ratio (INR) occurs with these agents making bridging to warfarin challenging.
Does bivalirudin increase PTT?
PTT (s): last measured PTT value. INR (unit-less): the last measured INR value – a coagulation time that is distinct, but associated with the PTT. It increases as the serum level of bivalirudin increases.
Does heparin increase INR?
Anticoagulant or anti-thrombotic drugs such as Heparin and Low Molecular Weight Heparin will cause the INR to be higher because they are affecting the coagulation cascade directly.
Which of the following anticoagulants is a direct inhibitor of thrombin?
Ximelagatran is the oral double prodrug of melagatran and was the first oral direct thrombin inhibitor developed. Studies demonstrated it to be as effective as the traditional anticoagulants in the prevention and treatment of venous and arterial thromboses and secondary prevention of cardiovascular events post MI.
How does Argatroban affect INR?
Argatroban prolongs the INR more than lepirudin or bivalirudin, and a higher-than-usual target INR during warfarin co-therapy (which depends on the thromboplastin reagent used to measure the INR) can be expected (see Caveats in Treatment of Heparin-Induced Thrombocytopenia).
How is bivalirudin monitoring?
At UWMC, bivalirudin is monitored using the Direct Thrombin Inhibitor (DTI) assay (Plasma-Diluted Thrombin Time). Used instead of aPTT to monitor injectable DTI therapy. Preferred over aPTT due to better sensitivity, and is not affected by antiphospholipid antibodies.
When do you use bivalirudin?
Angiomax is indicated for use as an anticoagulant for use in patients undergoing percutaneous coronary intervention (PCI) including patients with heparin-induced thrombocytopenia and heparin-induced thrombocytopenia and thrombosis syndrome.
