Why the study?
Do different coumarin derivatives have varying effects on the depression of coagulation factors II, VII, IX, and X during long-term treatment?
Do different coumarin derivatives have varying effects on the depression of coagulation factors II, VII, IX, and X during long-term treatment?
Prothrombin time and thrombotest remain the most reliable methods for monitoring anti-vitamin K action during long-term treatment, as separate determination of individual coagulation factors is unnecessary.
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Supports PT/Thrombotest monitoring across coumarins without factor assays; leaves open differential IX/X effects of shorter-acting agents.
Summary During long-term treatment with the long-acting coumarin derivative phenprocoumarol (marcoumar) no statistically significant difference in the depression of the activity of coagulation factors II, VII, IX, and X was found. The shorter-acting anticoagulants acenocoumarol (sintrom), warfarin sodium (coumadin), and dicoumarol, possibly lower factor IX somewhat less and factor X somewhat more than they do factors II and VII. A 2.5-fold prolongation of the “prothrombin” time (using Owren 5 s human brain thromboplastin) and the same prolongation of the thrombotest time appear to correspond with a depression of all four factors from 100% down to approximately 20’%, the normal standard being a mixed population with a mean age of 29 years. Separate determination of one of the four coagulation factors concerned is pointless; “prothrombin” time estimation, and more specifically thrombotest, still remain the most reliable methods for controlling the anti-vitamin K action of anticoagulants during long-term treatment.
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Loeliger et al. (1963) studied this question.
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