The predictability of bleeding by prothrombin times sensitive or insensitive to PIVKA during intensive oral anticoagulation.
To evaluate the effect of PIVKA (Proteins Induced by Vitamin K Absence or Antagonism) on the bleeding tendency during oral anticoagulation, we studied consecutive patients intensively treated with warfarin (INR greater than 4.8). The level of anticoagulation was measured with the PIVKA-insensitive Normotest (NT) as well as with the PIVKA-sensitive Thrombotest (TT), and the results are expressed as per cent coagulant activity. The NT/TT ratio was determined. Twenty patients with bleeding episodes had a mean NT/TT ratio of 2.06 as compared to 2.20 in 143 patients without bleeding episodes (p = 0.08). As the NT/TT ratio was not higher in patients with bleedings, we conclude that PIVKA are of no importance for bleeding during anticoagulation with vitamin K antagonists.
Arnesen
H
H
Red Cross Clinic, Oslo, Norway.
Smith
P
P
D000328:Adult; D000368:Aged; D015415:Biomarkers; D001777:Blood Coagulation / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D011498:Protein Precursors / Q000494:pharmacology*; D011516:Prothrombin / Q000494:pharmacology*; D011517:Prothrombin Time; D013925:Thromboplastin; D014859:Warfarin / Q000008:administration & dosage* / Q000627:therapeutic use
D015415:Biomarkers; D011498:Protein Precursors; C008208:acarboxyprothrombin; D014859:Warfarin; D011516:Prothrombin; D013925:Thromboplastin