Table 1:

Overview of some important facts on anticoagulation and ACT

ACT and Anticoagulation Facts

  • Celite, kaolin, and glass are activators used to measure ACT that yield different results

  • Celite-ACT is significantly longer than kaolin ACT

  • ACT values from a particular device are reproducible and correlate with anti-Xa values

  • ACT is device-specific even if the activator used is the same

  • ACT following administration of heparin varies based on heparin-dependent (heparin responsiveness/resistance) and heparin-independent (hemodilution, hypothermia, platelet count, race, and so forth) factors

  • LMWH anticoagulation can be monitored by ACT

  • Hemonox-CT is a more specific POC test for LMWH

  • Concomitant use of abciximab increases ACT; eptifibatide leads to less marked changes in ACT

  • Concomitant aprotinin administration affects Celite-ACT more than kaolin-ACT

  • Heparin concentrations are divided into high (>1 U/mL) and low (<1 U/mL)

  • Kaolin-based ACT is less accurate in low-intensity anticoagulation

  • Glass beads in a plastic tube are more effective in moderate heparin concentrations

  • Hemochron produces lower ACT values than the Automated Coagulation Timer System (previously HemoTec)

  • The corresponding anti-Xa values are needed to establish a therapeutic ACT range for a particular device

  • Institutions should establish their individual therapeutic ACT ranges