Advanced

Monitoring fondaparinux with the Sonoclot

Nilsson, Caroline LU and Engström, Martin LU (2007) In Blood Coagulation and Fibrinolysis 18(7). p.619-622
Abstract
Fondaparinux is a new anticoagulant that interacts with antithrombin III and activated coagulation factor X resulting in an inhibition of the coagulation system. It has been successful in doses of 2.5 mg for thromboprophylaxis as well as in higher therapeutic doses of 5-7.5 mg. No optimal method for monitoring the effects of fondaparinux has been proposed. The aim of the present study was to investigate whether a viscoelastic coagulation analyzer, the Sonoclot (Sienco, Denver, Colorado, USA), could be used for in-vitro monitoring of fondaparinux. Different concentrations of fondaparinux were added in vitro to whole blood taken from eight volunteers. The blood samples mixed with the various amounts of fondaparinux were analyzed using the... (More)
Fondaparinux is a new anticoagulant that interacts with antithrombin III and activated coagulation factor X resulting in an inhibition of the coagulation system. It has been successful in doses of 2.5 mg for thromboprophylaxis as well as in higher therapeutic doses of 5-7.5 mg. No optimal method for monitoring the effects of fondaparinux has been proposed. The aim of the present study was to investigate whether a viscoelastic coagulation analyzer, the Sonoclot (Sienco, Denver, Colorado, USA), could be used for in-vitro monitoring of fondaparinux. Different concentrations of fondaparinux were added in vitro to whole blood taken from eight volunteers. The blood samples mixed with the various amounts of fondaparinux were analyzed using the Sonoclot. The whole-blood activated partial thromboplastin time with the Hemochron Jr (ITC, Edison, New Jersey, USA) was used as the reference coagulation analysis. All analyses were started expeditiously, within 30s from sampling, and were performed at 37 degrees C. The values of the Sonoclot parameter clot rate, which measures the rate of fibrin formation, fibrin polymerization and platelet-fibrin interactions, were significantly correlated to increasing concentrations of fondaparinux (R= -0.90). The Sonoclot parameters of activated coagulation time, time to peak and clot retraction had weaker, butstill significant, correlations to fondaparinux concentrations. At prophylactic doses (0.38 mu g/ml blood) the clot rate decreased 15% compared with the initial unanticoagulated value, whereas at therapeutic doses (1.53 mu blood) there was a 27% decrease. In conclusion, the Sonoclot parameter clot rate could be of clinical value to individualize the fonclaparinux dosage, especially the higher, therapeutic, dosages. Blood Coagul Fibrinolysis 18:619-622 (c) 2007 Lippincott Williams & Wilkins. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
fondaparinux, activated partial thromboplastin time, deep vein thrombosis, monitoring, Sonoclot
in
Blood Coagulation and Fibrinolysis
volume
18
issue
7
pages
619 - 622
publisher
Lippincott Williams and Wilkins
external identifiers
  • wos:000250102400006
  • scopus:34748844022
ISSN
1473-5733
language
English
LU publication?
yes
id
67e34251-12bb-47e2-a9c7-73064d71f866 (old id 655445)
alternative location
http://www.bloodcoagulation.com/pt/re/bcf/abstract.00001721-200710000-00006.htm
date added to LUP
2007-12-14 15:42:01
date last changed
2017-01-01 04:40:33
@article{67e34251-12bb-47e2-a9c7-73064d71f866,
  abstract     = {Fondaparinux is a new anticoagulant that interacts with antithrombin III and activated coagulation factor X resulting in an inhibition of the coagulation system. It has been successful in doses of 2.5 mg for thromboprophylaxis as well as in higher therapeutic doses of 5-7.5 mg. No optimal method for monitoring the effects of fondaparinux has been proposed. The aim of the present study was to investigate whether a viscoelastic coagulation analyzer, the Sonoclot (Sienco, Denver, Colorado, USA), could be used for in-vitro monitoring of fondaparinux. Different concentrations of fondaparinux were added in vitro to whole blood taken from eight volunteers. The blood samples mixed with the various amounts of fondaparinux were analyzed using the Sonoclot. The whole-blood activated partial thromboplastin time with the Hemochron Jr (ITC, Edison, New Jersey, USA) was used as the reference coagulation analysis. All analyses were started expeditiously, within 30s from sampling, and were performed at 37 degrees C. The values of the Sonoclot parameter clot rate, which measures the rate of fibrin formation, fibrin polymerization and platelet-fibrin interactions, were significantly correlated to increasing concentrations of fondaparinux (R= -0.90). The Sonoclot parameters of activated coagulation time, time to peak and clot retraction had weaker, butstill significant, correlations to fondaparinux concentrations. At prophylactic doses (0.38 mu g/ml blood) the clot rate decreased 15% compared with the initial unanticoagulated value, whereas at therapeutic doses (1.53 mu blood) there was a 27% decrease. In conclusion, the Sonoclot parameter clot rate could be of clinical value to individualize the fonclaparinux dosage, especially the higher, therapeutic, dosages. Blood Coagul Fibrinolysis 18:619-622 (c) 2007 Lippincott Williams & Wilkins.},
  author       = {Nilsson, Caroline and Engström, Martin},
  issn         = {1473-5733},
  keyword      = {fondaparinux,activated partial thromboplastin time,deep vein thrombosis,monitoring,Sonoclot},
  language     = {eng},
  number       = {7},
  pages        = {619--622},
  publisher    = {Lippincott Williams and Wilkins},
  series       = {Blood Coagulation and Fibrinolysis},
  title        = {Monitoring fondaparinux with the Sonoclot},
  volume       = {18},
  year         = {2007},
}