What is the role of monitoring during anticoagulation therapy for hereditary and acquired hypercoagulability?

Updated: Jan 05, 2018
  • Author: Paul Schick, MD; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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In summary, it has been proposed that monitoring LMWH and direct thrombin inhibitors is not necessary since their effects are predictable. [53] This recommendation is in part due to the lack of reliability or unavailability of the tests for monitoring LMWH and thrombin inhibitors. For example, factor Xa levels are not reliable for determining whether the level of anticoagulation is sufficient to prevent thrombosis, as well as not reliable for predicting the risk for bleeding.

The inadequacy of monitoring tests and the fact that antidotes are not available places patients who bleed at considerable risk, especially because some of the LMWH and thrombin inhibitors have a long half-life. [54] The reversal of bleeding due to LMWH and thrombin inhibitors, especially if the agent has a long half-life, has been difficult.

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