Activated Clotting Time use with angiomax or bivalirudin
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Hello,
Our facility is seeking chest pain accreditation from American Cardiology Association and one of the guidelines is to run ACT with the administration of angiomax or bivalirudin. ACA accreditation rep has provided us with literature and guidelines that are already in place for ACT measurement with angiomax or bivalirudin use.
- Are there any ACT devices validated for use with angiomax or bivalirudin?
- How are POC sites addressing ACT measurement protocols when angiomax or bivalirudin is used?
Thank you in advance for your input!
Alka Arnold
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There is no ACT that the FDA has cleared for use with any other anticoagulant than heparin. That being said, both guidelines and drug labeling call for an ACT to be run when using most, if not all, alternative drugs.
The use of the ACT for monitoring these does officially make the test high complexity according to CLIA. In my experience, many sites validate the test by performing in vitro dose response studies with the drug of choice and their local ACT. In that way they demonstrate accuracy - there is a dose response, and precision by running multiple replicates of each sample.
There was a very good Whitehat communication webinar this morning regarding ACTs.
https://whitehatevents.webex.com/mw3300/mywebex/default.do?siteurl=whitehatevents&service=6&rnd=0.9870026076503964&main_url=%2Fec3300%2Feventcenter%2Fmainframe.do%3Fmainurl%3Dhttps%253A%252F%252Fwhitehatevents.webex.com%252Fec3300%252Fwebcomponents%252Fdocshow%252FecLandingPageAction.do%253Fsiteurl%253Dwhitehatevents%2526NM%253DPenny%252BGooch%2526AD%253Dpenny.gooch%252540va.gov%2526actionType%253Djoin%2526STD%253D1%2526rnd%253D0.9765437092418509%26siteurl%3Dwhitehatevents
ACT Testing: When There’s No Room for Doubt by Dr. Florian Falter, MD
Thank you Marcia and Penny for your prompt reply and helpful comments!