Activated clotting time as a screening test prior to catheter-based cardiovascular procedures.
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.
Siskin
G P
GP
Institute for Vascular Health and Disease, Albany Medical College, Albany, New York 12208, USA. gsiskin1@nycap.rr.com
Reiner
E
E
Stainken
B F
BF
Dowling
K
K
Dolen
E G
EG
Quarfordt
S
S
Albons
G
G
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