Quantitative Risk for Single-Positive Lupus Anticoagulant Results With Different Anticoagulants

Abstract

Objectives: Clinical experts recommend against testing for lupus anticoagulant (LAC) during anticoagulation.

Methods: We quantitated the risk of a single-positive dilute Russell viper venom time (dRVVT) result or partial thromboplastin time-based phospholipid neutralization (PN) result on anticoagulation.

Results: Any anticoagulation led to a fourfold greater likelihood of single-positive results, primarily by rivaroxaban (odds ratio [OR] = 8.6) and warfarin (OR = 6.6), resulting in a positive dRVVT test with a normal PN test. Heparin and apixaban were twofold more likely to show single-positive results, but enoxaparin did not show significant single positivity.

Conclusions: Our results quantitatively support experts' avoidance of LAC testing during anticoagulation.

Keywords: Anticoagulation; Heparin; Lupus anticoagulant; Warfarin.