Whole-blood Clotting Time, Activated Partial Thromboplastin Time, and Whole-blood Recalcification Time as Heparin Monitoring Tests

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Abstract
The authors performed whole-blood clotting time (WBCT), activated partial thromboplastin time (APTT), and wholeblood recalcification time (WBRCT) tests on normal blood or citrated plasma, each milliliter containing 0–0.5 unit heparin, and on samples from patients, of whom many were receiving heparin anticoagulation therapy. Six partial thromboplastin reagents were used. Linearity between clotting time and heparin concentration was observed with WBCT and APTT, determined with Hyland partial thromboplastin (kaolin-activated) and Dade (“Improved“ Activated Cephaloplastin and Actin®) reagents. With a General Diagnostics preparation (Platelin®-plus, celite as the activator) and another Hyland partial thromboplastin reagent (silica-activated), the sensitivity to heparin decreased to beyond 0.3 unit/ml plasma. No correlation was observed with the old Dade Activated Cephaloplastin reagent, WBRCT was completely insensitive to heparin in concentrations as high as 0.24 unit/ml blood. With patient samples, correlations were observed between WBCT and Hyland (kaolin) APTT, and between Hyland and Dade Actin® APTT. However, WBCT and WBRCT, and APTT and WBRCT, correlated poorly.

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