The ecarin chromogenic assay is a sensitive and precise new method for quantifying direct thrombin inhibitors like hirudin in plasma, without interference from heparin or oral anticoagulants.
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Should not yet change clinical monitoring of direct thrombin inhibitors; leaves open its role in assay standardization pending validation studies.
A new sensitive and precise method for quantitative determination of direct thrombin inhibitors is described, the ecarin chromogenic assay (ECA). Ecarin is used as the specific prothrombin-activating principle. The cleavage of a chromogenic substrate by meizothrombin is inhibited in a concentration-dependent fashion by direct thrombin inhibitors. For the ECA, the linear measuring range is about 0.1-3.0 microg hirudin/ml plasma. Coefficients of variations between 2.3 and 4% over the whole concentration range were achieved. The ECA has proved to be more sensitive than the compared tests (ecarin clotting time and a thrombin-based chromogenic assay); a detection limit of 0.011 microg hirudin/ml and a quantitation limit of 0.032 microg hirudin/ml were calculated. The ECA is independent of the variations of the coagulation variables fibrinogen and prothrombin. Neither heparin nor oral anticoagulants interfere with the ECA.
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Lange et al. (2003) studied this question.
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