Effective May 22, 2024, APTT Direct Thrombin Inhibitor (APTT DTI) will be performed at all Corewell Health West sites including Corewell Health Reference Laboratory and all regional labs (Corewell Health Big Rapids Hospital, Corewell Health Gerber Hospital, Corewell Health Grand Rapids Hospitals (Blodgett Hospital, Butterworth Hospital, Helen DeVos Children’s Hospital), Corewell Health Greenville Hospital, Corewell Health Ludington Hospital, Corewell Health Pennock Hospital, Corewell Health Reed City Hospital, Corewell Health Zeeland Hospital).
The APTT DTI is a clot based assay for monitoring the APTT in patients on direct thrombin inhibitors including Argatroban, Dabigatran, and Bivalrudin. This testing is for inpatient use only. The reference range for this assay is analyzer specific and is listed in the lab catalog (Current reference ranges: Corewell Health Reference Laboratory 23-28 seconds and Regional laboratories 24-34 seconds)
CLINICAL IMPLICATIONS
Direct thrombin inhibitors reversibly bind and inactivate thrombin thereby suppressing the coagulation at the last stage of the cascade. When heparin induced thrombocytopenia is suspected or confirmed argatroban or bivalirudin may be used as an alternate anticoagulant for unfractionated heparin and low molecular weight heparin. See individual direct thrombin inhibitor nomograms for therapeutic range.
TEST AND COLLECTION INFORMATION
APTT Direct Thrombin Inhibitor – Epic Code LAB1230880 – Interface code 1230880 – CPT 85730
