Anticoagulation is widely used in the inpatient setting for various indications for
both surgical and medical patients including stroke prevention in non-valvular atrial
fibrillation, prevention of venous thromboembolism in post-surgical patients, management
of acute coronary syndromes, and treatment of acute thrombosis. For patients with
acute thrombosis, anticoagulation is the key therapy to stabilize the thrombus, prevent
extension, and to prevent development of new thrombosis while risk factors are present
[
both surgical and medical patients including stroke prevention in non-valvular atrial
fibrillation, prevention of venous thromboembolism in post-surgical patients, management
of acute coronary syndromes, and treatment of acute thrombosis. For patients with
acute thrombosis, anticoagulation is the key therapy to stabilize the thrombus, prevent
extension, and to prevent development of new thrombosis while risk factors are present
[
]. Despite an expanding repertoire of anticoagulation options (including low molecular
weight heparin, oral Xa inhibitors, and intravenous and oral direct thrombin inhibitors),
intravenous unfractionated heparin (IV UFH) continues to have significant use in the
inpatient setting. Due to its variable pharmacokinetics and pharmacodynamics, monitoring
and dose titration of IV UFH is required and has been primarily accomplished with
use of the activated partial thromboplastin time (aPTT), although many institutions
are increasingly using the anti-Xa [
].
