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Testing lupus anticoagulants in a real-life scenario - a retrospective cohort study.

ABSTRACT: Lupus anticoagulant (LAC) testing is challenging. Most data are derived from a well-controlled study environment with potential alterations to daily routines. The aim of this retrospective cohort study was to assess the capacity of various LAC screening tests and derived mixing tests to predict a positive result in subsequent confirmation tests in a large cohort of patients.In 5832 individuals, we retrospectively evaluated the accuracy of the aPTT-A, aPTT-LAscreen, aPTT-FS and dRVVTscreen and of their derived mixing tests in detecting a positive confirmation test result within the same blood specimen. The group differences, degree of correlation and the predictive accuracy of LAC coagulation tests were analysed using the Mann-Whitney U test, the Spearman-rank-correlation and by area under the receiver operating characteristic curve (ROC-AUC) analysis. ROC-AUCs were compared with the Venkatraman´s permutation test.The pre-test probability of patients with clinically suspected LAC was 36% in patients without factor deficiency or anticoagulation therapy. The aPTT-LAscreen showed the best diagnostic accuracy with a ROC-AUC of 0.84 (95% CI: 0.82 - 0.86). No clear advantage of the dRVVT-derived mixing test was detectable when compared to the dRVVTscreen (P = 0.829). Usage of the index of circulating anticoagulant (ICA) did not improve the diagnostic power of respective mixing tests.Among the parameters evaluated, aPTT-LAscreen and derived mixing test parameters were the most accurate tests. In our study cohort, neither other mixing test nor the ICA presented any further advantage in LAC diagnostics.

SUBMITTER: Ratzinger F

PROVIDER: S-EPMC5575653 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Testing lupus anticoagulants in a real-life scenario - a retrospective cohort study.

Ratzinger Franz F Panic Tanja T Haslacher Helmuth H Perkmann Thomas T Schmetterer Klaus G KG Belik Sabine S Maenner Georg G Pabinger Ingrid I Quehenberger Peter P

Biochemia medica 20170828 3

<h4>Introduction</h4>Lupus anticoagulant (LAC) testing is challenging. Most data are derived from a well-controlled study environment with potential alterations to daily routines. The aim of this retrospective cohort study was to assess the capacity of various LAC screening tests and derived mixing tests to predict a positive result in subsequent confirmation tests in a large cohort of patients.<h4>Materials and methods</h4>In 5832 individuals, we retrospectively evaluated the accuracy of the aP ...[more]

PMID: 28900368

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Dataset Information

Testing lupus anticoagulants in a real-life scenario - a retrospective cohort study.

Publications

Testing lupus anticoagulants in a real-life scenario - a retrospective cohort study.

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