COAGULATION TESTS IN ANTICOAGULANT THERAPY

1965 ◽  
Vol 1 (5) ◽  
pp. 150-154 ◽  
Author(s):  
David W. Davies
Keyword(s):  
Anticoagulant Therapy ◽  
Coagulation Tests

scholarly journals Can We Measure the Individual Prothrombotic or Prohemorrhagic Tendency by Global Coagulation Tests?

2020 ◽  
Vol 40 (03) ◽  
pp. 364-378
Author(s):  
Sara Reda ◽  
Laure Morimont ◽  
Jonathan Douxfils ◽  
Heiko Rühl
Keyword(s):  
Anticoagulant Therapy ◽  
Thrombin Generation ◽  
Waveform Analysis ◽  
Laboratory Diagnostics ◽  
Coagulation Assays ◽  
Coagulation Process ◽  
Complex Process ◽  
Coagulation Tests ◽  
The Individual

AbstractHemostasis is a complex process in which abnormalities can cause shifts toward prothrombotic or prohemorrhagic states resulting in thrombosis or bleeding, respectively. Several coagulation tests may be required to characterize these defects but may yet not always reflect a patient's true hemostatic capacity. Thus, global coagulation tests aiming to simulate the coagulation process in vitro instead of measuring single components thereof are certainly of interest to assess prothrombotic or prohemorrhagic tendencies. This review describes the development and application of global coagulation tests, concentrating on the more widely used methods of viscoelastometry and thrombin generation. A focus is placed on conditions characterized by simultaneous changes of various components of hemostasis, such as anticoagulant therapy or hormone-induced coagulopathy, in which global coagulation tests are especially promising. If the key challenges of standardization and automation of these tests are solved, as is the case with automated thrombogram or clot waveform analysis, global coagulation assays will play an important role in the future of laboratory diagnostics of hemostasis and thrombosis.

THROMBOEMBOLISM IN PROSTHETIC VALVE ENDOCARDITIS AND ANTICOAGULANT THERAPY

1987 ◽  
Author(s):  
T Fukui ◽  
M Aosaki ◽  
Y Uetsuka ◽  
K Iwade ◽  
T Nirei ◽  
...  
Keyword(s):  
Blood Culture ◽  
Valve Replacement ◽  
Anticoagulant Therapy ◽  
Prosthetic Valve ◽  
White Blood Cells ◽  
Prosthetic Valve Endocarditis ◽  
Clinical Results ◽  
The Other ◽  
Coagulation Tests ◽  
Diagnostic Criterion

The clinical results of thromboembolism (TE) in Patients with prosthetic valVe endocarditis (PVE) and anticoagulant therapy were studied. 22 PVE patients (ll males and females each from 4 to 59 years old, average 32.7) were selected from 1939 patients who had undergone valve replacement at this hospital from 1964 and 1985. The complication frequency of TE and its clinical results, anticoagulant therapy and coagulation tests were investigated. Diagnostic criterion was determined in either of the following two: l) those patients who experienced valve replacement, with at least gradual pyrogenic symptons and inflammation factors such as a large increase in white blood cells, the progress of ESR and positive CRP, also with the same bacterium found more than twice in blood culture, also with the same bacterium found more than twice in blood culture, or 2) those patients who experienced valve replacement, with bacterial verruca found at re-valve replacement or at pathological anatomy. PVE onset took 2 days to 6.5 years (average 407 days) to appear after valve replacement. 8 out of the 22 PVE patients (36.3%) showed complications at TE onset, and 5 out of the 8 patients repeated. Embolism was found in 6 cases of brain, 4 cases of kidney, 2 cases of lung, 2 cases of limbs and 1 case of spleen, and 8 patients all died. On the other hand, 5 complications (22.7%) at bleeding were found in 3 cases of brain, 1 case of duodenum and 1 case of site of replaced aortic valve, and 4 patients died. Anticoagulant therapy was given to 21 out of the 22 PVE patients, and thrombotest (TT) values at TE onset were all less than 30%. Warfarin was administered as anticoagulant. 2 patients were administered with aspirin, but one was given with 250mg aspirin per day together with warfarin, and the other with 330mg aspirin per day alone. TT values at the onset of bleeding were from 10 to 56%. Anticoagulant therapy had been performed to the PVE patients since PVE onset did not yet appear, but complications coagulability by TT values, and all the patients died. In addition to this, complications at bleeding were found many and most of patients died even when the TT values were not so low. Therefore, we believe that the anticoagulant therapy that had been performed after PVE onset still needs further studies.

scholarly journals Hemolysis has no influence on routine coagulation tests in subjects without anticoagulant therapy - a referral Romanian emergency hospital laboratory experience

2019 ◽  
Vol 27 (4) ◽  
pp. 375-382
Author(s):  
Elena Binzari ◽  
Mihaela Zaharia ◽  
Stefan Barbu ◽  
Oana Roxana Oprea ◽  
Minodora Dobreanu
Keyword(s):  
Anticoagulant Therapy ◽  
Human Subjects ◽  
Reference Interval ◽  
Reference Intervals ◽  
Healthy Human ◽  
Visual Scale ◽  
Coagulation Tests ◽  
Before And After ◽  
Hemolysis Rate

Abstract The aim of this study was to determine the rate of hemolyzed specimens sent to our laboratory for coagulation testing, assess the interference of hemolysis on coagulation for patients without anticoagulant therapy and to determine the reference intervals for PT, INR and aPTT for our laboratory in order to test our own limitations. Methods: To determine the hemolysis rate, 1,689 specimens were evaluated on a visual scale and with the hemolysis icterus lipemia (HYL) test on Architect c4000 instrument. 125 blood samples collected from subjects without anticoagulant therapy were hemolyzed in vitro and the PT, INR and aPTT results were compared before and after hemolysis.To determine reference intervals (RI) for PT, INR and aPTT in our population, 125 apparently healthy human subjects (according to CLSI C28-A2) were enrolled and tests were performed on Sysmex CS 2000i, using Siemens reagents. Results: Out of 1,689 samples, 9.46% were assessed as hemolyzed by the visual scale, while HYL test showed a 6.63% hemolysis rate. We found a shortening of 0.1s for PT, a diminution with 0.01 units for INR and a prolongation with 0.9s for aPTT from in vitro hemolyzed compared to non-lyzed samples. As to the reference intervals, we obtained in our laboratory versus reagents producer: for PT 9.8-13.9 s vs 9.8-12.1 s, and for aPTT 19.1-31.5s vs 23-31.9 s respectively; 28.38% more PT results and 13.44% more aPTT results were within range when we used local laboratory RI, compared to the manufacturer’s RI. Conclusions: The rate of hemolyzed coagulation samples in our laboratory is higher than the rate found in the literature. Nevertheless, for patients without anticoagulant therapy hemolyzed samples should be processed. Using our own reference interval leads to a significant reduced number of abnormal results.

scholarly journals AB0305 IS THERE HYPERCOAGULATION IN PATIENTS WITH ANTIPHOSPHOLIPID SYNDROME AND BEHCET’S DISEASE?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1178.2-1179
Author(s):  
N. Seredavkina ◽  
T. Reshetnyak ◽  
T. Lisitsyna ◽  
A. Lila
Keyword(s):  
Disease Activity ◽  
Behçet’S Disease ◽  
Antiphospholipid Syndrome ◽  
Anticoagulant Therapy ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Unknown Etiology ◽  
Thrombin Time ◽  
Behcet's Disease ◽  
Coagulation Tests

Background:Whereas antiphospholipid syndrome (APS) is a non-inflammatory vasculopathy and is associated with thrombosis in 98% of cases, Behcet’s disease (BD) is a systemic vasculitis of unknown etiology, characterized by vascular damage of any calibre. Both venous and arterial thromboses occur in 45% of BD patients and are associated not with hypercoagulable disease but with inflammatory changes in the vascular wall mediated by hypersecretion of pro-inflammatory cytokines and endothelial cells dysfunction. Thrombodynamics (TD) is a new global test for diagnosing plasma haemostasis disorders, identifying bleeding and thrombosis risks, and can be used to detect a prothrombotic state and assess the influence of disease activity and course on the hypercoagulation process.Objectives:comparative assessment of TD in patients with APS and BD before anticoagulant therapy (AC).Methods:The study included 20 patients (9 APS and 11 BD) and 8 age and sex-matched healthy controls (HC). None of the subjects received AC. Thromboses in past history were registered in 5/9 (55%) APS patients and 2/11 (18%) BD patients and none of HC. Fetal loss occurred only in women with APS (4/4 (100%) who had pregnancy during the disease). All the patients were hospitalized and underwent fool investigation according to the diagnosis including TD, local coagulation tests and antiphospholipid antibodies profile.Results:the velocity of clot growth in APS was lower, than in BD and in HC: 23.7 [22.6; 24.7] vs 29.0 [28.2; 34.4] and 31.1 [28.9; 33.5] Um/min, respectively (р=0.001). Clot size at 30 minutes in APS also was lower, than in BD and HC: 972.1 [921.3; 1007.4] vs 1152.7 [1098.3; 1225.4] and 1226.6 [1140.5; 1295.1] Um, respectively (р=0.001). Spontaneous clotting was registered only in 2 BD patients in mean time 2 minutes. Clot density and lag time (Tlag, the delay between the test start and the onset of clot formation) were the same in all three groups. Prolonged APTT was found in APS (33.7 [30.6; 47.1] sec) and normal APTT - in BD (30.9 [29.1; 31.1] sec) and HC (29.7 [28.2; 30.8] sec). Increased soluble fibrin-monomer complexes were revealed in all APS patients (100%), 91% BD patients and 25% HC (р=0.01). After interpretation the TD results were distributed as follows: hypocoagulation was noted in 1 APS patient with a positive lupus anticoagulant, while all other APS patients had normocoagulation. Thrombotic readiness status (TRS) was diagnosed only in 2 BD patients. The frequency of normocoagulation and hypercoagulation did not differ between BD and HC. Local coagulation tests (APTT, thrombin time, prothrombin time) were the same depending on hypo- and hypercoagulation by TD results. Fibrinogen level in BD patients with hypercoagulation was higher, than in BD patients with normocoagulation and TRS: 4.2 [3.6; 4.7] vs 2.8 [2.7; 3.0] and 2.8 [2.7;2.8] g/l respectively, р=0.04. BD activity by Behcet’s Disease Current Activity Form correlated with stationary velocity of clot growth (Rs = 0.68, p<0.05).Conclusion:Thrombodynamics results showed: before anticoagulant therapy there were normocoagulation with a tendency to hypocoagulation in APS and hypercoagulation in BD. In BD hypercoagulation associated with disease activity.Disclosure of Interests:None declared

Relative Sensitivity of Different Tests in the Detection of Low Titer Lupus Anticoagulants

1988 ◽  
Vol 60 (02) ◽  
pp. 217-219 ◽  
Author(s):  
B Lesperance ◽  
M David ◽  
J Rauch ◽  
C Infante-Rivard ◽  
G E Rivard
Keyword(s):  
Relative Sensitivity ◽  
Fetal Outcome ◽  
Anticardiolipin Antibodies ◽  
Lupus Anticoagulants ◽  
Normal Plasma ◽  
Coagulation Tests ◽  
High Dilutions ◽  
Tissue Thromboplastin ◽  
High Concentrations ◽  
Kaolin Clotting Time

SummaryLupus anticoagulants (LA) and anticardiolipin antibodies have been strongly associated with recurrent abortion and fetal death. Because steroids have been reported to improve the fetal outcome of LA associated pregnancies, presumably by decreasing the levels of LA, it becomes desirable to have a simple and reliable test to monitor the levels of the putative antibody. To this effect, we assessed the capacity of the following coagulation tests to detect the presence of LA in serial dilutions of patient plasma with pooled normal plasma: kaolin clotting time (KCT), tissue thromboplastin inhibition test (TTIT), dilute Russell Viper venom time (DRVVT) and activated partial thromboplastin time with standard and high concentrations of phospholipids (SC and HCAPTT). All samples were also evaluated for the presence of anticardiolipin antibodies with an ELISA. The KCT was able to detect LA at a much greater dilution in normal plasma than any of the other clotting assays. The ELISA was comparable to KCT in its ability to detect high dilutions of LA.

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