Article of the Month – January 2022 – Richard Dutton, Kevin Blaine and Roman Dudaryk
Highlights
- Do you have any experience in this area?
Summary:
There's limited evidence that the visco elastic tests measure factor ten inhibiters in a reliable way. If i get a test result back of, say, take tegs our time, if i got a teg our time of nine point o, that could be therapeutically anticoagulated on some patients in a doac. But what i can't do is reliably prolong that into a range that is abnormal. Do you have any experience in this area? You probably don’t see as many older trima patients as roman does in miami, but what has your experience been? Ye, so this is an area that i i've a lot of interest in.
Transcript:
Speaker 2
Let
Speaker 3
me ask you the same question, kevan. Do you have any experience in this area? You probably don't see as many older trima patients as roman does in miami, but what has your experience been? Ye,
Speaker 1
so this is an area that i i've a lot of interest in. I would agree that one issue that we have is that there's limited evidence that the visco elastic tests measure factor ten inhibiters in a reliable way. So which is to say that i can get your c t time or your r time, i can prolong that with a ten a inhibiter. But what i can't do is reliably prolong that into a range that is abnormal. Which is to say, if i get a test result back of, say, take tegs our time, if i got a teg our time of nine point o, that could be therapeutically anticoagulated on some patients in a doac, or that could be normal in a patient who was sub therapeutic on a doac. (Time 0:12:30)
- Is there a Visco Elastic Test for Doac?
Summary:
There's limited evidence that the visco elastic tests measure factor ten inhibiters in a reliable way. I'm really intrigued some of the the newer experimental assays that romans discussing as an agonist. They're using an icelit from the russell viper, which is, i believe, a south asian venomous cobra. And that particular toxin specifically activates factor ten and maximmly activates it. But we're not, we're not there yet.
Transcript:
Speaker 3
Ye,
Speaker 1
so this is an area that i i've a lot of interest in. I would agree that one issue that we have is that there's limited evidence that the visco elastic tests measure factor ten inhibiters in a reliable way. So which is to say that i can get your c t time or your r time, i can prolong that with a ten a inhibiter. But what i can't do is reliably prolong that into a range that is abnormal. Which is to say, if i get a test result back of, say, take tegs our time, if i got a teg our time of nine point o, that could be therapeutically anticoagulated on some patients in a doac, or that could be normal in a patient who was sub therapeutic on a doac. It is really hard to judge that test as diagnostic test. I'm really intrigued some of the the newer experimental assays that romans discussing as an agonist. They're using an icelit from the russell viper, which is, i believe, a south asian venomous cobra. And that particular toxin specifically activates factor ten and maximmly activates it. So i'm, i'm really hopeful that this new line of research, this new line of tests, might actually be able to pick up the doaks. But we're not, we're not there yet. And similarly with the anti platelod agents, you know, it comes down to that question of normal range. The currently the only visco elastic test for playlets is the hemonetic a teg platlet mapping, which is available now in cartridge form and in the cup form, depending under h platform. And you know, the problem there is that the range of normal for inhibition encompasses the entire range from zero to a hundred % inhibition. And that has to do with the fact that there are patients that have known polymorphisms in the at p receptor. So your your aracadonic acid assays is going to be unreliable, because some people like their base line test is a hundred % indivition. (Time 0:12:40)
- Aracadonic Acid Assay For Playlets
Summary:
The currently the only visco elastic test for playlets is the hemonetic a teg platlet mapping, which is available now in cartridge form and in the cup form. And you know, the problem there is that the range of normal for inhibition encompasses the entire range from zero to a hundred % inhibition. similarly with the anti platelod agents, it comes down to that question of normal range.
Transcript:
Speaker 1
And similarly with the anti platelod agents, you know, it comes down to that question of normal range. The currently the only visco elastic test for playlets is the hemonetic a teg platlet mapping, which is available now in cartridge form and in the cup form, depending under h platform. And you know, the problem there is that the range of normal for inhibition encompasses the entire range from zero to a hundred % inhibition. And that has to do with the fact that there are patients that have known polymorphisms in the at p receptor. So your your aracadonic acid assays is going to be unreliable, because some people like their base line test is a hundred % indivition. I'm sory, that was the eight p assay for the racadonic acid assay, which theoretically picks up insets. The test is fairly ative. There's a great study, and i love quoting it, where they had a patient saves at british study, where they had patients lick an 81 milligram aspirant, and they produced so much inhibition, they produced a hundred % inhibition at four hours. And i don't think anybody's going to think that licking an aspirant tablet is truly functional plalet inhibition. So we're not their yet with using the platelet mapping essays as diagnostic testand it's worth remembering that the way that they're supposed to be used is that you get a base line on patients prior to them getting a dual antiplate letherapy for stents. And then based on that base line inhibition, you then would titrate their op or their asprin to reach a therapeutic range of inhibition. (Time 0:13:57)
Article of the Month – January 2022 – Richard Dutton, Kevin Blaine and Roman Dudaryk
Highlights
- Do you have any experience in this area?
Summary:
There's limited evidence that the visco elastic tests measure factor ten inhibiters in a reliable way. If i get a test result back of, say, take tegs our time, if i got a teg our time of nine point o, that could be therapeutically anticoagulated on some patients in a doac. But what i can't do is reliably prolong that into a range that is abnormal. Do you have any experience in this area? You probably don’t see as many older trima patients as roman does in miami, but what has your experience been? Ye, so this is an area that i i've a lot of interest in.
Transcript:
Speaker 2
Let
Speaker 3
me ask you the same question, kevan. Do you have any experience in this area? You probably don't see as many older trima patients as roman does in miami, but what has your experience been? Ye,
Speaker 1
so this is an area that i i've a lot of interest in. I would agree that one issue that we have is that there's limited evidence that the visco elastic tests measure factor ten inhibiters in a reliable way. So which is to say that i can get your c t time or your r time, i can prolong that with a ten a inhibiter. But what i can't do is reliably prolong that into a range that is abnormal. Which is to say, if i get a test result back of, say, take tegs our time, if i got a teg our time of nine point o, that could be therapeutically anticoagulated on some patients in a doac, or that could be normal in a patient who was sub therapeutic on a doac. (Time 0:12:30)
- Is there a Visco Elastic Test for Doac?
Summary:
There's limited evidence that the visco elastic tests measure factor ten inhibiters in a reliable way. I'm really intrigued some of the the newer experimental assays that romans discussing as an agonist. They're using an icelit from the russell viper, which is, i believe, a south asian venomous cobra. And that particular toxin specifically activates factor ten and maximmly activates it. But we're not, we're not there yet.
Transcript:
Speaker 3
Ye,
Speaker 1
so this is an area that i i've a lot of interest in. I would agree that one issue that we have is that there's limited evidence that the visco elastic tests measure factor ten inhibiters in a reliable way. So which is to say that i can get your c t time or your r time, i can prolong that with a ten a inhibiter. But what i can't do is reliably prolong that into a range that is abnormal. Which is to say, if i get a test result back of, say, take tegs our time, if i got a teg our time of nine point o, that could be therapeutically anticoagulated on some patients in a doac, or that could be normal in a patient who was sub therapeutic on a doac. It is really hard to judge that test as diagnostic test. I'm really intrigued some of the the newer experimental assays that romans discussing as an agonist. They're using an icelit from the russell viper, which is, i believe, a south asian venomous cobra. And that particular toxin specifically activates factor ten and maximmly activates it. So i'm, i'm really hopeful that this new line of research, this new line of tests, might actually be able to pick up the doaks. But we're not, we're not there yet. And similarly with the anti platelod agents, you know, it comes down to that question of normal range. The currently the only visco elastic test for playlets is the hemonetic a teg platlet mapping, which is available now in cartridge form and in the cup form, depending under h platform. And you know, the problem there is that the range of normal for inhibition encompasses the entire range from zero to a hundred % inhibition. And that has to do with the fact that there are patients that have known polymorphisms in the at p receptor. So your your aracadonic acid assays is going to be unreliable, because some people like their base line test is a hundred % indivition. (Time 0:12:40)
- Aracadonic Acid Assay For Playlets
Summary:
The currently the only visco elastic test for playlets is the hemonetic a teg platlet mapping, which is available now in cartridge form and in the cup form. And you know, the problem there is that the range of normal for inhibition encompasses the entire range from zero to a hundred % inhibition. similarly with the anti platelod agents, it comes down to that question of normal range.
Transcript:
Speaker 1
And similarly with the anti platelod agents, you know, it comes down to that question of normal range. The currently the only visco elastic test for playlets is the hemonetic a teg platlet mapping, which is available now in cartridge form and in the cup form, depending under h platform. And you know, the problem there is that the range of normal for inhibition encompasses the entire range from zero to a hundred % inhibition. And that has to do with the fact that there are patients that have known polymorphisms in the at p receptor. So your your aracadonic acid assays is going to be unreliable, because some people like their base line test is a hundred % indivition. I'm sory, that was the eight p assay for the racadonic acid assay, which theoretically picks up insets. The test is fairly ative. There's a great study, and i love quoting it, where they had a patient saves at british study, where they had patients lick an 81 milligram aspirant, and they produced so much inhibition, they produced a hundred % inhibition at four hours. And i don't think anybody's going to think that licking an aspirant tablet is truly functional plalet inhibition. So we're not their yet with using the platelet mapping essays as diagnostic testand it's worth remembering that the way that they're supposed to be used is that you get a base line on patients prior to them getting a dual antiplate letherapy for stents. And then based on that base line inhibition, you then would titrate their op or their asprin to reach a therapeutic range of inhibition. (Time 0:13:57)