Comparison of markers of coagulation activation in patients under oral anticoagulation at different levels.
Three groups of patients receiving oral anticoagulation treatment were evaluated. The groups consisted of patients with mechanical heart valve prosthesis (n = 60), patients after coronary bypass graft surgery (n = 60) and patients using oral anticoagulation after deep venous thrombosis or pulmonary embolism (n = 60). The patient groups were subdivided into three groups of 20 patients, each group receiving different levels of oral anticoagulation as indicated by the international normalized ratio (INR). Prothrombin fragment 1 + 2, thrombin-antithrombin III complexes and fibrin monomers were determined as coagulation activation makers. The prothrombin fragments 1 + 2 were INR dependent in all groups whereas the thrombin-antithrombin III values were only INR dependent in the group of patients with mechanical heart valve prosthesis. For fibrin monomers no correlation with the INR levels could be found. These results indicate that prothrombin fragment 1 + 2 is the only laboratory quantity of the three, which provides a suitable index of low thrombin activity during anticoagulation therapy.
van Wersch
J W
JW
Haematological Laboratory, De Wever Ziekenhuis, Heerlen, The Netherlands.
van Mourik-Alderliesten
C H
CH
Coremans
A
A
D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D000990:Antithrombin III / Q000032:analysis*; D001777:Blood Coagulation; D005260:Female; D005337:Fibrin / Q000032:analysis*; D006801:Humans; D008297:Male; D010446:Peptide Fragments / Q000032:analysis*; D010447:Peptide Hydrolases / Q000032:analysis*; D011516:Prothrombin / Q000032:analysis*
D000925:Anticoagulants; D010446:Peptide Fragments; C046193:antithrombin III-protease complex; C045879:prothrombin fragment 1.2; D000990:Antithrombin III; D011516:Prothrombin; D005337:Fibrin; D010447:Peptide Hydrolases