scholarly journals Assessment of Stability of Prothrombin Time, International Normalized Ratio, and Activated Partial Thromboplastin Time Under Different Storage Conditions in Human Plasma

Cureus ◽  
2022 ◽  
Author(s):  
Parag Patil ◽  
Tushar Sehgal ◽  
Priyanka Goswami ◽  
Malvika Gaur ◽  
Maroof Khan ◽  
...  
2021 ◽  
Vol 121 (1) ◽  
pp. 22-31
Author(s):  
Alіna Baylo ◽  
Vadym Shypulіn ◽  
Volodymyr Chernyavskyi ◽  
Luiza Parunyan

The comorbid course of liver cirrhosis and atrial fibrillation causes higher levels of hospitalizations, mortality and ischemic stroke. According to current data, hemostasis in patients with liver cirrhosis is in a rebalanced dynamic state, but there are no data on the effect of atrial fibrillation on the hemostasis in patients with liver cirrhosis. Aims of the study. To assess abnormalities in primary, secondary haemostasis and fibrinolytic system in patients with liver cirrhosis and atrial fibrillation by using standard laboratory coagulation parameters and to investigate their changes depending on the stage of liver cirrhosis A, B, C according to Child-Pugh score. Materials and methods. A cross-sectional prospective study was conducted with the inclusion of 106 patients aged 42 to 83 years: group I (n = 70) - with liver cirrhosis and atrial fibrillation, II (n = 36) - with liver cirrhosis, which were distributed depending on the Child-Pugh score stages of cirrhosis and 20 healthy individuals. The levels of platelets, activated partial thromboplastin time, international normalized ratio, prothrombin time, thrombin time, fibrinogen, D-dimer were assessed on a Steellex M200 coagulometer. Statistical analysis (IBM SPSS Statistics) was performed. Results. The level of platelets in patients of group I was reduced by 37.4% (200 ± 8.33 vs. 274.7 ± 3.4; p,000.001), an activated partial thromboplastin time was prolonged by 38.6% (44.35 ± 1.39 vs. 32.01 ± 0.63, p˂0.001), prothrombin time was prolonged by 73.5% (19.4 ± 0.87 vs. 11.18 ± 0.53, p˂0.001), thrombin time was prolonged by 2.07 (25, 7 ± 1.31 vs. 12.4 ± 0.66, p˂0.001), the international normalized ratio was increased by 24.3% (1.38 ± 0.04 vs.1.11 ± 0.01, p˂0.001) compared to control. The fibrinogen level was 20.9% higher (4.17 ± 0.17 vs. 3.45 ± 0.11, p˂0.001) than in control group and was 83.7% higher (4.17 ± 0.17 vs. 2.27 ± 0.13, p˂0.001) than in group II. The D-dimer level was 83% higher than in control (675 ± 22.3 vs. 368.8 ± 21.85, p˂0.001) and 44% higher (675 ± 22.3 vs. 469 ± 37.18, p ˂0.001) compared with group II. Conclusions. In patients with liver cirrhosis and atrial fibrillation abnormalities of primary hemostasis are detected due to decrease of platelets on the background of portal hypertension. At the secondary stage of hemostasis indicators of external and internal coagulation mechanisms are prolonged due to the reduced synthesis of coagulation factors by the liver. Increased level of fibrinogen is determined at the stage of compensated and subcompensated cirrhosis with a gradual decrease at the stage of decompensation. The high activity of the fibrinolytic system is observed due to increase in the D-dimer levels, which may indicate a prothrombotic state in these patients.


2009 ◽  
Vol 21 (5) ◽  
pp. 674-678 ◽  
Author(s):  
Stefania Casella ◽  
Claudia Giannetto ◽  
Francesco Fazio ◽  
Elisabetta Giudice ◽  
Giuseppe Piccione

The aim of the present study was to assess the effect of different storage conditions on prothrombin time (PT), activated partial thromboplastin time (aPTT), and fibrinogen concentration in clinical samples from healthy horses. A total of 100 healthy horses of varying breeds and gender, ranging in age from 4 to 18 years, with a mean body weight of 480 + 70 kg, were used. Blood was collected by jugular venipuncture, and a hemochrome-cytometric examination was conducted on all samples. All blood samples were centrifuged and divided into 4 different aliquots to assess clotting parameters by means of a coagulometer. The first aliquots were analyzed 1 hr after collection, the second aliquots were refrigerated at 8°C for 6 hr, the third aliquots were frozen at −20°C for 24 hr, and the fourth aliquots were frozen at −20°C for 48 hr. Significant differences ( P < 0.05) were determined by one-way analysis of variance with repeated measures, and statistical analysis showed a significant effect of the experimental conditions on all parameters studied. In particular, the results demonstrated that coagulation tests can be done within 6 hr when samples are stored at 8°C because the short-term refrigeration does not change the result of analyses; storage at −20°C is acceptable only after 24 hr for PT, aPTT, and fibrinogen measurements because after 48 hr, freezing alters the values of clotting parameters. Therefore, the results of this investigation indicate that clotting parameters remain stable only up to 24 hr in horses without adversely affecting hemostasis test results.


Author(s):  
N. V. Galeeva ◽  
I. E. Kravchenko

Goal of the study is to reveal the particular features of hemostasis in patients with chronic hepatitis C in dynamics of natural course of disease. Materials and methods. The indices of hemostasis in 535 patients with chronic hepatitis C were assessed by the number of platelets, degree of their aggregation with the use of inductor of adenosine triphosphate and without it (spontaneous aggregation of platelets). Coagulative hemostasis was analyzed by the activated partial thromboplastin time, antitrombin III, prothrombin ratio, prothrombin time, fibrinogen concentration in plasma and international normalized ratio. Based on the number of Tr, typical for the disseminated intravascular coagulation syndrome, conditionally the patients were divided into 3 groups: I group - hypercoagulability; II - transient phase between hyper and hypocoagulation and III- hypocoagulation, which also included patients with liver cirrhosis. Results and discussion. Independent on the phase of disseminated intravascular coagulation syndrome, increase of aggregation of Tr with the growth of maximal amplitude was observed. The main part of studied indices of coagulative hemostasis indicated at the condition of hypocoagulation in patients with chronic hepatitis C - this is significant increase of activated partial thromboplastin time, prothrombin time, international normalized ratio and decrease of fibrinogen concentration in the studied groups by the phases of disseminated intravascular coagulation syndrome. Value of antitrombin III changed oppositely, it decreased, so that plasma hemostasis tends to the hypercoagulation. Conclusion. Under the chronic hepatitis C all phases of disseminated intravascular coagulation syndrome were observed with the disorder of thrombocytic coagulative hemostasis. There was followed up multidirectional change of hemostasis which obtained in the most cases character of delitescent course of disseminated intravascular coagulation syndrome.


Author(s):  
N. V. Galeeva ◽  
I. E. Kravchenko

Goal of the study is to reveal the particular features of hemostasis in patients with chronic hepatitis C in dynamics of natural course of disease. Materials and methods. The indices of hemostasis in 535 patients with chronic hepatitis C were assessed by the number of platelets, degree of their aggregation with the use of inductor of adenosine triphosphate and without it (spontaneous aggregation of platelets). Coagulative hemostasis was analyzed by the activated partial thromboplastin time, antitrombin III, prothrombin ratio, prothrombin time, fibrinogen concentration in plasma and international normalized ratio. Based on the number of Tr, typical for the disseminated intravascular coagulation syndrome, conditionally the patients were divided into 3 groups: I group - hypercoagulability; II - transient phase between hyper and hypocoagulation and III- hypocoagulation, which also included patients with liver cirrhosis. Results and discussion. Independent on the phase of disseminated intravascular coagulation syndrome, increase of aggregation of Tr with the growth of maximal amplitude was observed. The main part of studied indices of coagulative hemostasis indicated at the condition of hypocoagulation in patients with chronic hepatitis C - this is significant increase of activated partial thromboplastin time, prothrombin time, international normalized ratio and decrease of fibrinogen concentration in the studied groups by the phases of disseminated intravascular coagulation syndrome. Value of antitrombin III changed oppositely, it decreased, so that plasma hemostasis tends to the hypercoagulation. Conclusion. Under the chronic hepatitis C all phases of disseminated intravascular coagulation syndrome were observed with the disorder of thrombocytic coagulative hemostasis. There was followed up multidirectional change of hemostasis which obtained in the most cases character of delitescent course of disseminated intravascular coagulation syndrome.


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