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January 1, 1979Thrombosis and Haemostasis

Spectrophotometric Assays of Prothrombin in Plasma of Patients Using Oral Anticoagulants

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Why the study?

Are spectrophotometric factor II assays as useful as prothrombin time in the control of oral anticoagulation?

Population

Patients using oral anticoagulants (both long-term and starting treatment)

Comparison

Spectrophotometric assays for prothrombin vs One stage coagulant assay, immunological assay…

Design

Other

Authors

RBRogier M. BertinaLeiden University Medical CenterWNW van der Marel-van NieuwkoopLeiden UniversityELE.A. LoeligerNetherlands Organisation for Applied Scientific Research

Discussion

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Implication

Factor II assays unlikely to supplant prothrombin time for anticoagulation monitoring; leaves open XAPC/ECAR utility in long-term patients.

Key Points

  • To develop and evaluate two spectrophotometric prothrombin assays for monitoring oral anticoagulation compared to conventional clotting and immunological methods.
  • Developed the XAPC assay using factor Xa, phospholipid, calcium, and factor V to selectively measure fully carboxylated, normal prothrombin.
  • Developed the ECAR assay using Echis carinatus snake venom to quantify both normal prothrombin and subcarboxylated prothrombin (PIVKA II).
  • Compared assay performance and XAPC/ECAR ratios against one-stage clotting tests (Thrombotest) in patients either initiating or maintained on long-term oral anticoagulation.
  • The XAPC/ECAR ratio reliably detected and quantified prothrombin subcarboxylation resulting from vitamin K antagonism.
  • Thrombotest clotting times correlated better with the ratio of normal prothrombin to total prothrombin (XAPC/ECAR) than with isolated factor II concentrations during long-term therapy.
  • No correlation was found between Thrombotest clotting times and the XAPC/ECAR ratio during initiation of oral anticoagulation, demonstrating insufficient utility compared to standard prothrombin time.

Structured PICO

Are spectrophotometric factor II assays as useful as prothrombin time in the control of oral anticoagulation?

P
Population
Patients using oral anticoagulants (both long-term and starting treatment)
I
Intervention
Spectrophotometric assays for prothrombin (XAPC and ECAR assays)
C
Comparator
One stage coagulant assay, immunological assay, and prothrombin time (Thrombotest)
O
Outcome
Correlation between spectrophotometric assay results and prothrombin timesurrogate

Spectrophotometric factor II assays are unlikely to be as useful as standard prothrombin time for monitoring oral anticoagulation.

Cite This Study

Bertina et al. (1979) studied this question.

synapsesocial.com/papers/6a6f78c3fe4101aa97dfcb4chttps://doi.org/10.1055/s-0038-1657025

Topics

Anticoagulation in AF
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1SPECIFIC DETERMINATIONS OF PROTHROMBIN DURING ANTICOAGULANT TREATMENT1972 · 2 citations
  2. 2The Inhibitor of Prothrombin Conversion in Plasma of Patients on Oral Anticoagulant Treatment1981 · 33 citations
  3. 3An Evaluation of Chromogenic Substrates in the Control of Oral Anticoagulant Therapy1981 · 27 citations
  4. 4Multicenter Evaluation of a Chromogenic Substrate Method for Photometric Determination of Prothrombin Time1987 · 42 citations
  5. 5Control of oral anticoagulant treatment by chromogenic prothrombin assay.1987 · 4 citations