Blood Res 2014; 49(2):
Published online June 25, 2014
https://doi.org/10.5045/br.2014.49.2.85
© The Korean Society of Hematology
Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH, United States.
Correspondence to : Correspondence to Heesun J. Rogers, M.D., Ph.D. Department of Laboratory Medicine, Cleveland Clinic, 9500 Euclid Avenue (L-11), Cleveland, OH 44195, United States. Tel: +216-445-2719, Fax: +216-444-4414, rogersj5@ccf.org
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Hypercoagulability can result from a variety of inherited and, more commonly, acquired conditions. Testing for the underlying cause of thrombosis in a patient is complicated both by the number and variety of clinical conditions that can cause hypercoagulability as well as the many potential assay interferences. Using an algorithmic approach to hypercoagulability testing provides the ability to tailor assay selection to the clinical scenario. It also reduces the number of unnecessary tests performed, saving cost and time, and preventing potential false results. New oral anticoagulants are powerful tools for managing hypercoagulable patients; however, their use introduces new challenges in terms of test interpretation and therapeutic monitoring. The coagulation laboratory plays an essential role in testing for and treating hypercoagulable states. The input of laboratory professionals is necessary to guide appropriate testing and synthesize interpretation of results.
Keywords Hypercoagulability, Algorithmic approach, Antiphospholipid syndrome, Direct oral anticoagulant, Venous thromboembolism
Blood Res 2014; 49(2): 85-94
Published online June 25, 2014 https://doi.org/10.5045/br.2014.49.2.85
Copyright © The Korean Society of Hematology.
Megan O. Nakashima, and Heesun J. Rogers*
Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH, United States.
Correspondence to: Correspondence to Heesun J. Rogers, M.D., Ph.D. Department of Laboratory Medicine, Cleveland Clinic, 9500 Euclid Avenue (L-11), Cleveland, OH 44195, United States. Tel: +216-445-2719, Fax: +216-444-4414, rogersj5@ccf.org
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Hypercoagulability can result from a variety of inherited and, more commonly, acquired conditions. Testing for the underlying cause of thrombosis in a patient is complicated both by the number and variety of clinical conditions that can cause hypercoagulability as well as the many potential assay interferences. Using an algorithmic approach to hypercoagulability testing provides the ability to tailor assay selection to the clinical scenario. It also reduces the number of unnecessary tests performed, saving cost and time, and preventing potential false results. New oral anticoagulants are powerful tools for managing hypercoagulable patients; however, their use introduces new challenges in terms of test interpretation and therapeutic monitoring. The coagulation laboratory plays an essential role in testing for and treating hypercoagulable states. The input of laboratory professionals is necessary to guide appropriate testing and synthesize interpretation of results.
Keywords: Hypercoagulability, Algorithmic approach, Antiphospholipid syndrome, Direct oral anticoagulant, Venous thromboembolism
Comprehensive hypercoagulability testing panel using a diagnostic algorithm. Abbreviations: aPTT, activated partial thromboplastin time; B2GP1, beta2 glycoprotein 1; CRP, C-reactive protein; DRVVT, dilute Russell's Viper Venom test; MTHFR, methylenetetrahydrofolate reductase; PL, phospholipid; PNP, platelet neutralization procedure; PT, prothrombin time; SNP, single nucleotide polymorphism.
Table 1 . Acquired and hereditary risk factors for thrombophilia..
a)Can be hereditary or acquired..
Table 2 . The recommended assays for different types of DOAC monitoring..
Abbreviations: aPTT, activated partial thromboplastin time; DOAC, direct oral anticoagulant; PT, prothrombin time; TT, thrombin time..
Ho-Young Yhim
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Comprehensive hypercoagulability testing panel using a diagnostic algorithm. Abbreviations: aPTT, activated partial thromboplastin time; B2GP1, beta2 glycoprotein 1; CRP, C-reactive protein; DRVVT, dilute Russell's Viper Venom test; MTHFR, methylenetetrahydrofolate reductase; PL, phospholipid; PNP, platelet neutralization procedure; PT, prothrombin time; SNP, single nucleotide polymorphism.