Comparison of MAX-ACT and K-ACT Values When Using Bivalirudin Anticoagulation During Minimally Invasive Hybrid Off-Pump Coronary Artery Bypass Graft Surgery

Department of Anesthesia & Perioperative Medicine, University of Western Ontario, London, Ontario, Canada.
Journal of cardiothoracic and vascular anesthesia (Impact Factor: 1.48). 02/2011; 25(3):415-8. DOI: 10.1053/j.jvca.2010.12.007
Source: PubMed

ABSTRACT To compare the kaolin-activated coagulation time (K-ACT) to the MAX-ACT for monitoring anticoagulation with bivalirudin in patients undergoing hybrid off-pump coronary artery revascularization procedures.
A prospective, observational study.
A cardiac surgical operating room of a university-affiliated hospital.
Twelve patients undergoing off-pump coronary artery bypass graft surgery and percutaneous coronary intervention during the same procedure anticoagulated with bivalirudin to a target K-ACT of >300 seconds.
At baseline and at frequent intervals during anticoagulation, K-ACT and MAX-ACT assays were run contemporaneously, and the pairs of results were analyzed with descriptive statistics, by correlation analysis, and with Bland-Altman analysis.
The MAX-ACT and K-ACT assays were highly correlated, but the MAX-ACT assay consistently reported significantly lower ACT values compared with the K-ACT. The mean bias (K-ACT minus MAX-ACT) was 94 seconds (limits of agreement, 51-138 seconds).
To maximize patient safety, centers using bivalirudin for anticoagulation during cardiac surgical procedures need to be aware of the different performance characteristics of ACT assay subtypes.

  • Source
    Nucleic Acids Research 03/1990; 18(4):1051. DOI:10.1093/nar/18.4.1051 · 9.11 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Chlamydomonas reinhardtii cells treated with toluene at 0 degrees C and 25 degrees C incorporate ribonucleoside triphosphates (NTPs) into chloroplast RNA at 25 degrees C and also at 35 degrees C. The incorporation requires all four NTPs and Mg2+, and is completely inhibited by DNase, RNase, actinomycin D (40 microgram/ml) and rifampicin (350 microgram/ml). However, the incorporation is almost totally insensitive to both alpha-amanitin and streptolydigin at 200 microgram/ml.
    European Journal of Biochemistry 06/1979; 96(1):125-9. DOI:10.1111/j.1432-1033.1979.tb13021.x · 3.58 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Plant sigma factors determine the promoter specificity of the major RNA polymerase of plastids and thus regulate the first level of plastome gene expression. In plants, sigma factors are encoded by a small family of nuclear genes, and it is not yet clear if the family members are functionally redundant or each paralog plays a particular role. The review presents the analysis of the information on plant sigma factors obtained since their discovery a decade ago and focuses on similarities and differences in structure and functions of various paralogs. Special attention is paid to their interaction with promoters, the regulation of their expression, and their role in the development of a whole plant. The analysis suggests that though plant sigma factors are basically similar, at least some of them perform distinct functions. Finally, the work presents the scheme of this gene family evolution in higher plants.
    Plant Cell Reports 08/2007; 26(7):845-59. DOI:10.1007/s00299-007-0318-7 · 2.94 Impact Factor
Show more