title: Activated clotting time as a screening test prior to catheter-based cardiovascular procedures.
abstract: The activated clotting time (ACT) was investigated as a rapid, inexpensive, point-of-service screening test for coagulation abnormalities prior to catheter-based procedures. A total of 963 patients were screened by obtaining a history, standard coagulation profile, and activated coagulation time. The prevalence of normal patients (normal ACT and coagulation profile) was 94% (sensitivity = 91%; specificity = 27%). A normal ACT had a positive predictive value of 95%. The ACT was an acceptable screening test due to its ability to predict positively a low rate of bleeding complication and normal coagulation studies. Patients with ACT > 150 sec should be further evaluated with a screening coagulation panel. Additionally, given its low specificity, coagulation studies should be obtained in high-risk patients since an abnormal ACT does not effectively correlate with abnormal coagulation studies.
authors.affiliation: Institute for Vascular Health and Disease, Albany Medical College, Albany, New York 12208, USA. gsiskin1@nycap.rr.com
authors.forename: G P
authors.initials: GP
authors.lastname: Siskin
authors.forename: E
authors.initials: E
authors.lastname: Reiner
authors.forename: B F
authors.initials: BF
authors.lastname: Stainken
authors.forename: K
authors.initials: K
authors.lastname: Dowling
authors.forename: E G
authors.initials: EG
authors.lastname: Dolen
authors.forename: S
authors.initials: S
authors.lastname: Quarfordt
authors.forename: G
authors.initials: G
authors.lastname: Albons
mesh_terms: D001778:Blood Coagulation Disorders / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology*; D016063:Blood Loss, Surgical / Q000503:physiopathology; D006328:Cardiac Catheterization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014914:Whole Blood Coagulation Time