title: No indication for APTT screening in patients on oral anticoagulant therapy.
abstract: Patients on oral anticoagulant therapy (OAT) may bleed due to a very low factor IX level caused by a mutation at Ala-10 in the propeptide region of the factor IX gene. We evaluated screening of patients on OAT with an APTT to detect patients with this abnormality. In 734 patients an APTT was assessed. Twenty-three patients had a disproportionately prolonged APTT. In these patients the factor IX level, the mutation at Ala-10 and the frequency of bleeding complications were assessed. No severely lowered factor IX levels were found (1 patient with 5% factor IX). No mutations at Ala-10 were found and bleeding complications were not more frequent in these patients.
  
  
  CONCLUSIONS
  Routine APTT screening of patients on OAT is not useful to detect patients with increased bleeding or with the Ala-10 mutation in the factor IX gene.
authors: Department of Hematology, Leiden University Medical Center, The Netherlands. van_der_Meer@clinhematology.medfac.leidenuniv.nl
authors: F J
authors: FJ
authors: van der Meer
authors: H L
authors: HL
authors: Vos
authors: F R
authors: FR
authors: Rosendaal
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects*; D005164:Factor IX / Q000235:genetics* / Q000378:metabolism; D005820:Genetic Testing; D006470:Hemorrhage / Q000175:diagnosis / Q000517:prevention & control*; D006801:Humans; D009154:Mutation; D010314:Partial Thromboplastin Time
chemical_list: D000925:Anticoagulants; D005164:Factor IX