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Advances in Hematology
Volume 2016, Article ID 4054806, 6 pages
http://dx.doi.org/10.1155/2016/4054806
Review Article

Clinical Scenarios for Discordant Anti-Xa

1Internal Medicine, Texas Tech University Health Sciences Center at the Permian Basin, 800 W. 4th Street, Odessa, TX 79763, USA
2Texas Tech University Health Sciences Center School of Pharmacy at Dallas, 5920 Forrest Park Lane, Suite 400, Dallas, TX 75235, USA
3University of the Incarnate Word Feik School of Pharmacy, 4301 Broadway, San Antonio, TX 78209, USA
4Departamento de Biología Celular y Tisular, Facultad de Medicina, UNAM, 04510 México, DF, Mexico
5Servicio de Gastrocirugía, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, 06720 México, DF, Mexico

Received 16 February 2016; Accepted 27 April 2016

Academic Editor: Elvira Grandone

Copyright © 2016 Jesus Vera-Aguilera et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Anti-Xa test measures the activity of heparin against the activity of activated coagulation factor X; significant variability of anti-Xa levels in common clinical scenarios has been observed. Objective. To review the most common clinical settings in which anti-Xa results can be bias. Evidence Review. Guidelines and current literature search: we used PubMed, Medline, Embase, and MEDION, from 2000 to October 2013. Results. Anti-Xa test is widely used; however the assay underestimates heparin concentration in the presence of significant AT deficiency, pregnancy, end stage renal disease, and postthrombolysis and in patients with hyperbilirubinemia; limited published data evaluating the safety and effectiveness of anti-Xa assays for managing UH therapy is available. Conclusions and Relevance. To our knowledge this is the first paper that summarizes the most common causes in which this assay can be affected, several “day to day” clinical scenarios can modify the outcomes, and we concur that these rarely recognized scenarios can be affected by negative outcomes in the daily practice.