Статті в журналах: "Thromboplastin – analysis"

1

Triplett, DA, JT Brandt, MA Batard, JL Dixon, and DS Fair. "Hereditary factor VII deficiency: heterogeneity defined by combined functional and immunochemical analysis." Blood 66, no. 6 (December 1, 1985): 1284–87. http://dx.doi.org/10.1182/blood.v66.6.1284.1284.

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Abstract Twenty-six patients with hereditary factor VII deficiency (VII:C less than 10%) were evaluated using a panel of three thromboplastins of varying species and tissue origin in both coagulant and chromogenic assay systems. Normal values for the coagulation and chromogenic assays were 104% +/- 7% and 108% +/- 21%, respectively. Factor VII antigen was measured by a specific radioimmunoassay (normal, 470 +/- 112 ng/mL). The patients were divided into two groups based on the factor VII:Ag assay results. Group 1, 18 patients, had decreased levels of factor VII:Ag and group 2, eight patients, had normal levels of factor VII:Ag. The two groups were further subdivided on the basis of discrepant factor VII:C levels in the chromogenic and coagulant assays. The number of observed patterns of functional factor VII:C activity suggests a high degree of complexity of factor VII and thromboplastin interaction. Whereas no clinical bleeding was reported in any of the nine black patients evaluated, all Caucasians (16) and one Hispanic presented with mild to severe bleeding. Patients with factor VII:C greater than 10% using a human thromboplastin had a negative bleeding history, regardless of the activity measured with other thromboplastins. Factor VII activity measured with a human thromboplastin appears to correlate best with the clinical picture.

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2

Triplett, DA, JT Brandt, MA Batard, JL Dixon, and DS Fair. "Hereditary factor VII deficiency: heterogeneity defined by combined functional and immunochemical analysis." Blood 66, no. 6 (December 1, 1985): 1284–87. http://dx.doi.org/10.1182/blood.v66.6.1284.bloodjournal6661284.

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Twenty-six patients with hereditary factor VII deficiency (VII:C less than 10%) were evaluated using a panel of three thromboplastins of varying species and tissue origin in both coagulant and chromogenic assay systems. Normal values for the coagulation and chromogenic assays were 104% +/- 7% and 108% +/- 21%, respectively. Factor VII antigen was measured by a specific radioimmunoassay (normal, 470 +/- 112 ng/mL). The patients were divided into two groups based on the factor VII:Ag assay results. Group 1, 18 patients, had decreased levels of factor VII:Ag and group 2, eight patients, had normal levels of factor VII:Ag. The two groups were further subdivided on the basis of discrepant factor VII:C levels in the chromogenic and coagulant assays. The number of observed patterns of functional factor VII:C activity suggests a high degree of complexity of factor VII and thromboplastin interaction. Whereas no clinical bleeding was reported in any of the nine black patients evaluated, all Caucasians (16) and one Hispanic presented with mild to severe bleeding. Patients with factor VII:C greater than 10% using a human thromboplastin had a negative bleeding history, regardless of the activity measured with other thromboplastins. Factor VII activity measured with a human thromboplastin appears to correlate best with the clinical picture.

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3

Downey, Colin, Louise Dwyre, and Cheng Toh. "Thromboplastin Sensitivity in Waveform Analysis." Thrombosis and Haemostasis 84, no. 09 (2000): 517–18. http://dx.doi.org/10.1055/s-0037-1614055.

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4

Meethal, Shahana Jahan Kulathinte, Ravikrishnan Jayakumar, Suresh Kumar Sreenivasan, Shaffeek Abdul Majeed, and Indira Kariveettil. "Laboratory Wise Variations in Prothrombin Time - INR - A Cross Sectional Study in Trivandrum, Kerala." Journal of Evidence Based Medicine and Healthcare 8, no. 24 (June 14, 2021): 2112–16. http://dx.doi.org/10.18410/jebmh/2021/395.

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BACKGROUND Prothrombin time (PT) is routinely used as a test of coagulation. Thromboplastin is the key ingredient in the reagent for this test. Prothrombin time international normalized ratio (INR) readings can vary according to the thromboplastin used in the reagent. The composition of thromboplastin reagents can influence the sensitivity of each batch of reagents. Various thromboplastin reagents having different international sensitivity index (ISI) values are available now. This study was intended to evaluate the effect of different thromboplastins on INR reading for mitral valve replaced patients under stable oral anticoagulant therapy. METHODS The study was conducted on the citrated plasma received from the mitral valve replaced patients having stable international ratio between 2 to 3 for three months. 62 samples were collected from the clinical pathology laboratory, Govt. Medical College, Trivandrum. Each sample was tested with different thromboplastin reagents having international sensitivity index 1.0, 1.1 and 1.6 by measurement of the prothrombin time and conversion into international normalized ratio. The INR obtained from the thromboplastin with international sensitivity index 1.0 was considered as the standard. INR results obtained from samples tested with thromboplastin reagents with ISI 1.1 and 1.6 were compared with the standard by using analysis of variance (ANOVA) and Dunnett’s post hoc tests. RESULTS Sixty-two samples were tested with the thromboplastin reagent having ISI – 1.0, the mean INR is 2.42, for ISI – 1.1 mean INR value is 2.53 and for ISI 1.6, the mean INR value is 3.19. While comparing the mean value of INR for different reagents using ANOVA, the F value was 14.86, which was significant. P value less than 0.01. In the Dunnett post hoc test, the P value of difference between ISI 1.0/1.6 was < 0.01. Between ISI 1.1/1.6 also the P value is < 0.01. Both of these were significant. The P value of difference between the reagents having ISI 1.0 and 1.1 is 0.838 which denotes no significant difference. CONCLUSIONS In conclusion, the thromboplastin reagent with ISI 1.0 or nearest to 1.0 is most desirable for accurate INR report. KEYWORDS Prothrombin Time, International Sensitivity Index, International Normalized Ratio

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5

Kazama, Mutsuyoshi, Setsuko Suzuki, Takeshi Abe, Chieko Tahara, Chisato Shimazu, Yoshiko Akiyama, Katsumi Higashi, et al. "Evaluation of International Normalized Ratios by a Controlled Field Survey with 4 Different Thromboplastin Reagents." Thrombosis and Haemostasis 64, no. 04 (1990): 535–41. http://dx.doi.org/10.1055/s-0038-1647353.

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SummaryA nationwide survey has been performed in Japan involving 75 laboratories to assess the relative reliability of different methods of reporting prothrombin time results in anticoagulant control. The interchangeability of results using prothrombin time, prothrombin activity percentage, prothrombin ratio and international normalized ratios (INR) were compared with four different thromboplastin reagents and a range of coagulometers. A secondary batch of reference thromboplastin of human brain origin (BCT/454) was used to calibrate the local thromboplastins and for comparison of methods of reporting. The study revealed the closest agreement of the results between BCT and the other reagents, and the regression lines of these reagents were almost identical, when the results were reported as INR. Box-Whisker plot analysis showed that the distribution of the results was large with the more deficient plasmas with all methods of reporting. It was found by this analysis that the interchangeability of the results was greatest when the results were expressed by INR, because the mean values obtained of each plasma using different thromboplastin reagents gave the lowest CV and the frequency of the far-out data was least, compared with the other methods of expression. On the other hand, the type of coagulometer had almost as much effect as the thromboplastin reagent on the prothrombin time, even if INR was used. Interchangeability of INR would be further improved by providing ISI values for each reagent/ instrument combination.

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6

Lazo-Langner, Alejandro, Rosario Villa-Márquez, Darinel Hernández-Hernández, Sonia Rojas-Maya, and Josefa Piedras. "Intrahospital Correlation of the International Normalized Ratio." Clinical and Applied Thrombosis/Hemostasis 15, no. 2 (April 1, 2008): 220–24. http://dx.doi.org/10.1177/1076029608315167.

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Background. Monitoring of oral anticoagulant therapy (OAT) is usually accomplished by measuring prothrombin time and the international normalized ratio (INR). However, thromboplastins have different responsiveness and sensitivity to vitamin K—dependent coagulation factors depletion. Several studies have shown INR variation when low sensitive thromboplastins are used. This study compared INR variability between two laboratories using highly sensitive thromboplastins. Methods. A total of 237 plasmas were tested, half of them from patients under OAT. Samples were tested simultaneously in two laboratories: in laboratory A, a Behring Coagulation Timer instrument and a human recombinant thromboplastin (Innovin, Dade Behring) (ISI 1.01) were used. In laboratory B, a Thrombolyzer Compact (Behnk Elektronik) and a rabbit brain thromboplastin (Simplastin Excel S, Organon Teknika) with an ISI of 1.30 were used. Statistical analysis was carried out according to the method of Bland and Altman. Results. Even though high correlation coefficients were obtained when comparing both laboratories, Bland—Altman analysis showed a variation of INR between laboratories ranging from −0.77 to +1.07. After logarithmic transformation of data, these values yielded a variation of the INR either 25% below or 44% above. Conclusions. These results are clearly inadequate for clinical use because such a variation would most probably induce the clinician to make a change in warfarin dose. Standardization of instruments, reagents, and controls is warranted to decrease this variation.

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7

Douglas, Alexander D., Jo Jefferis, Rishi Sharma, Rachel Parker, Ashok Handa, and Jonathan Chantler. "Evaluation of Point-of-care Activated Partial Thromboplastin Time Testing by Comparison to Laboratory-based Assay for Control of Intravenous Heparin." Angiology 60, no. 3 (April 26, 2009): 358–61. http://dx.doi.org/10.1177/0003319709332958.

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Introduction Patients on intravenous heparin require regular activated partial thromboplastin time monitoring. Laboratory-based activated partial thromboplastin time assays necessitate a delay between blood sampling and dose adjustment. Point-of-care testing could permit immediate dose adjustments, potentially enabling tighter control of anticoagulation. Aim To assess equivalence of activated partial thromboplastin time measured by conventional laboratory assay and by a novel proprietary point-of-care testing system (Hemochron Response, ITC, Thoratec Corporation, Edison, NJ) among surgical ward patients on intravenous heparin. Methods A total of 39 blood samples from patients on intravenous heparin were tested with both laboratory and point-of-care assays. Assay equivalence was assessed by Bland-Altman analysis. Results. Point-of-care measurements exceeded laboratory activated partial thromboplastin time by a mean of 15 seconds (standard deviation 19). In 19 cases (49%), the point-of-care measurement would have resulted in different heparin dosing from the laboratory activated partial thromboplastin time. Conclusions The Hemochron Response system is not sufficiently accurate for routine ward use compared with laboratory activated partial thromboplastin time assays.

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8

Wada, Hideo, Takeshi Matsumoto, Kohshi Ohishi, Katsuya Shiraki, and Motomu Shimaoka. "Update on the Clot Waveform Analysis." Clinical and Applied Thrombosis/Hemostasis 26 (January 1, 2020): 107602962091202. http://dx.doi.org/10.1177/1076029620912027.

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The activated partial thromboplastin time (APTT)–clot waveform analysis (CWA) was previously reported to be associated with the early detection of disseminated intravascular coagulation and was also reported to be able to measure very low levels of coagulation factor VIII activity. The software program for the analysis for the APTT-CWA allows the associated first and second derivative curves (first and second DCs) to be displayed. The first and second DC reflect the velocity and acceleration, respectively. The height of the first DC reflects the “thrombin burst” and bleeding risk, while that of the second DC is useful for detecting any coagulation factor deficiency and abnormal enhancement of coagulation by phospholipids. Activated partial thromboplastin time-CWA aids in making a differential diagnosis which is difficult to do using only the routine APTT. The CWA is currently used for many applications in the clinical setting, including the monitoring of hemophilia patients and patients receiving anticoagulant therapy and the differential diagnosis of diseases.

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9

Kogan, Alexander E., Denis V. Kardakov, and Mikhail A. Khanin. "Analysis of the Activated Partial Thromboplastin Time Test Using Mathematical Modeling." Thrombosis Research 101, no. 4 (February 2001): 299–310. http://dx.doi.org/10.1016/s0049-3848(00)00405-9.

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10

Gannon, Michelle, and Pamela B. Simone. "Impact of a Nurse-Driven Heparin Monitoring Protocol for Ventricular Assist Devices." AACN Advanced Critical Care 32, no. 2 (June 15, 2021): 146–51. http://dx.doi.org/10.4037/aacnacc2021803.

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Background: Ventricular assist devices require anticoagulation to reduce thrombosis risk. Nurse-driven unfractionated heparin monitoring protocols have been validated for various indications, although data in patients with ventricular assist devices are lacking. Objective: To evaluate a nurse-driven protocol for managing unfractionated heparin therapy in stable patients with ventricular assist devices. Methods: This was a retrospective analysis of adult patients with ventricular assist devices requiring unfractionated heparin therapy, divided into 2 groups: before and after protocol implementation. The primary outcome was time to first therapeutic activated partial thromboplastin time. Results: Each group included 29 patients. There was no difference between the preintervention and postintervention groups in time to therapeutic activated partial thromboplastin time (25 vs 23 hours, P = .95) or proportion of patients with therapeutic activated partial thromboplastin time within the first 24 hours (45% vs 34%, P = .42). Suspected pump thrombosis and bleeding events were similar in the 2 groups. Conclusion: A nurse-driven heparin monitoring protocol was similar in time to therapeutic activated partial thromboplastin time compared with provider-driven monitoring and adjustments in patients with ventricular assist devices.

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11

Chopin, Nicolas, Bernard Floccard, Frédéric Sobas, Julien Illinger, Emmanuel Boselli, Farida Benatir, Albrice Levrat, et al. "Activated partial thromboplastin time waveform analysis: A new tool to detect infection?*." Critical Care Medicine 34, no. 6 (June 2006): 1654–60. http://dx.doi.org/10.1097/01.ccm.0000217471.12799.1c.

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12

Templin, K., M. Shively, and J. Riley. "Accuracy of drawing coagulation samples from heparinized arterial lines." American Journal of Critical Care 2, no. 1 (January 1, 1993): 88–95. http://dx.doi.org/10.4037/ajcc1993.2.1.88.

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OBJECTIVE: To determine the accuracy of activated partial thromboplastin time and prothrombin time studies when samples are drawn through heparinized arterial lines. METHODS: A total sample of 90 grouped blood samples (from 30 subjects) was used. Patients were all male, with a mean age of 65 and were studied within 24 hours of percutaneous transluminal coronary angioplasty. Each patient had three venous control and arterial line sample sets (a total of 90 blood samples) drawn when routinely ordered for monitoring therapy. For the arterial line sample, a discard volume of the deadspace, deadspace + 2 mL, or deadspace + 4 mL was randomly assigned for each sample. The venous control volumes were the same for all three sample sets. RESULTS: A 2 x 3 repeated measures analysis of variance was used to analyze the results. The independent variables were the source of the sample (venous vs arterial) and the discard volume of arterial blood (deadspace, deadspace + 2 mL, deadspace + 4 mL). The dependent variables were the activated partial thromboplastin time and prothrombin time values. Mean arterial activated partial thromboplastin time values were significantly higher than the corresponding venous values. Mean activated partial thromboplastin time values were not significantly different among the discard volumes of blood drawn. However, there was a significant source by volume interaction. Tukey post-hoc comparisons of venous-arterial activated partial thromboplastin time differences among the three volumes showed significant differences between deadspace volume and deadspace + 2 mL, and deadspace volume and deadspace + 4 mL. There was no significant difference between deadspace + 2 mL and deadspace + 4 mL volumes. CONCLUSION: Results indicated that the minimal amount of discard volume for accurate activated partial thromboplastin time values in this population of percutaneous transluminal coronary angioplasty patients was the catheter deadspace volume plus 2 mL (total 3.6 mL).

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13

Mani, Mohan Prasath, Saravana Kumar Jaganathan, Ahmad Zahran Khudzari, Rajasekar Rathanasamy, and Praseetha Prabhakaran. "Single-stage electrospun innovative combination of polyurethane and neem oil: Synthesis, characterization and appraisal of blood compatibility." Journal of Bioactive and Compatible Polymers 33, no. 6 (August 9, 2018): 573–84. http://dx.doi.org/10.1177/0883911518792288.

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Wound healing is a complex process and it requires proper scaffolding for regeneration. An ideal scaffold should provide optimal environmental conditions in order to assist cellular attachment, proliferation and differentiation. In this work, a new composite based on polyurethane and neem oil was fabricated using one-step electrospinning technique. Fabricated composite patch along with the pristine polyurethane was characterized through scanning electron microscopy, Fourier transform and infrared spectroscopy, thermogravimetric analysis, contact angle measurement and atomic force microscopy. Moreover, the blood compatibility was evaluated using activated partial thromboplastin time, partial thromboplastin time and haemolysis assay. Scanning electron microscopy studies of composites revealed the existence of fibres with a smaller diameter (635 ± 105 nm) compared to the pristine polyurethane (969 ± 217 nm). Fourier transform and infrared analysis revealed the formation of hydrogen bond and peak shifting characteristics confirming the interaction of the neem oil with the polyurethane. Contact angle analysis showed the decrease in contact angle indicating the hydrophilic nature of the fabricated patch compared to pristine polyurethane. Thermal gravimetric analysis depicted the better thermal stability of the novel composite patch due to the existence of neem oil in the pristine polyurethane. The presence of neem oil in polyurethane matrix also resulted in an increase in the surface roughness as observed in the AFM analysis. The novel composite patch showed an ability to reduce the thrombogenicity and promoting the anticoagulant nature signified by blood compatibility assays like activated partial thromboplastin time and partial thromboplastin time. Finally, the haemolytic percentage of the fabricated composite (1%) was found to be reduced compared to control (2.733%) indicating better blood compatibility and safety with the red blood cells. Following the results, the fabricated patches offered enhanced physicochemical and blood compatible nature making it as a promising candidate for wound healing application.

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14

Rosborough, Terry K. "Comparing Different Lots of Activated Partial Thromboplastin Time Reagent: Analysis of Two Methods." American Journal of Clinical Pathology 110, no. 2 (August 1, 1998): 173–77. http://dx.doi.org/10.1093/ajcp/110.2.173.

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15

Ivey, Leesa M., James Y. Thom, and Ross I. Baker. "Single or duplicate analysis for automated prothrombin time and activated partial thromboplastin time?" Pathology 29, no. 1 (1997): 67–71. http://dx.doi.org/10.1080/00313029700169574.

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16

Williams-Norwood, Tanya, Megan Caswell, Barbara Milner, Joseph C. Vescera, Kelly Prymicz, Amy G. Ciszak, Carol Ingle, Christopher Lacey, and Evi X. Stavrou. "Design and Implementation of an Anti–Factor Xa Heparin Monitoring Protocol." AACN Advanced Critical Care 31, no. 2 (June 15, 2020): 129–37. http://dx.doi.org/10.4037/aacnacc2020132.

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Background: The VA Northeast Ohio Healthcare System introduced a new nurse-driven anti–factor Xa (anti-Xa) protocol for monitoring unfractionated heparin to replace the previous activated partial thromboplastin time protocol. Objective: To design, implement, and evaluate the efficacy of the anti-Xa monitoring protocol. Methods: An interdisciplinary team of providers collaborated to develop and implement a nurse-driven, facility-wide anti–factor Xa protocol for monitoring unfractionated heparin therapy. The effectiveness of this protocol was evaluated by retrospective analysis. Results: We reviewed 100 medical records for compliance with the new anti-Xa monitoring protocol. We then evaluated 178 patients whose anticoagulation was monitored with the anti-Xa assay to determine the time to therapeutic range. We found that 80% of patients receiving the anti-Xa protocol achieved therapeutic anticoagulation within 24 hours, as compared with 54% of patients receiving the activated partial thromboplastin time protocol (P < .001). Protocol conversion also yielded a decrease in blood draws, dose adjustments, and potential calculation errors. Conclusions: Monitoring intravenous heparin therapy with the anti-Xa assay rather than activated partial thromboplastin time resulted in a shorter time to therapeutic anticoagulation, longer maintenance of therapeutic levels, and fewer laboratory tests and heparin dosage changes. We believe the current practice of monitoring heparin treatment with activated partial thromboplastin time assays should be reexamined.

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17

Storozhuk, N. V., T. M. Chernyshenko, B. H. Storozhuk, E. V. Luhovskoy, L. O. Storozhuk, E. P. Kostyuchenko, and T. M. Platonova. "Initiatory markers of thrombinemia in patients with ischemic heart disease and coronary angioplasty." Reports of Vinnytsia National Medical University 22, no. 4 (December 28, 2018): 626–29. http://dx.doi.org/10.31393/reports-vnmedical-2018-22(4)-08.

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The search for initiatory thrombinemia markers in patients with ischemic heart disease (IHD) and coronary angioplasty is significant for preventing stenting restenosis/thrombosis. Objective — determination of initiatory markers of thrombinemia in patients with ischemic heart disease and coronary angioplasty. Functionally inactive forms of prothrombin (FIFP), soluble fibrin (sF), international normalized attitude, and activated partial thromboplastin time were found out in 92 patients (78 men and 14 women) with coronary angioplasty, of which 33 cases had a history with stent placental restenosis. Statistical processing was performed by methods of variation statistics and correlation analysis. FIFP, which were determined by the ratio of ecomulsion index/prothrombin index in this category of patients, is veraciously increased, as well as the level of sF. At the same time the patients with restenosis in the history had significantly higher concentration of sF than the patients without occlusion. It is established that activated partial thromboplastin time in patients with restenosis is reliably prolonged, which may be evidence of activation of the anticoagulation system in the initiatory stages of prethrombosis. Individually taken indices of ecomulsion index, prothrombin index, international normalized attitude, activated partial thromboplastin time, in the absence of the appointment of either direct or indirect anticoagulants, are not informative. A complex assessment of hemostasis is required to detect initiatory thrombinemia markers (ecomulsion index/prothrombin index, international normalized attitude, activated partial thromboplastin time, sF).

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18

Nordfang, Ole, Sanne Valentin, Thomas C. Beck, and Ulla Hedner. "Inhibition of Extrinsic Pathway Inhibitor Shortens the Coagulation Time of Normal Plasma and of Hemophilia Plasma." Thrombosis and Haemostasis 66, no. 04 (1991): 464–67. http://dx.doi.org/10.1055/s-0038-1646439.

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SummaryAn increasing amount of evidence suggests that coagulation factors VIII and IX play a role not only in the intrinsic but also in the extrinsic pathway of coagulation. In this context the influence of the Extrinsic Pathway Inhibitor (EPI) on the coagulation time of hemophilia plasma lacking FVIII or FIX has been investigated. The coagulation time was measured in a dilute thromboplastin assay. Addition of recombinant EPI (rEPI) prolonged the coagulation time of normal plasma while the addition of an inhibitory antibody against EPI shortened the coagulation time. At low concentrations of thromboplastin the coagulation time of hemophilia plasma was prolonged and at all dilutions of thromboplastin, addition of anti-EPI IgG normalized the coagulation time of a hemophilia plasma. Analysis of 10 individual donor plasma samples and 8 individual hemophilia samples showed that addition of anti-EPI IgG shortened the coagulation time more in hemophilia plasma than in normal plasma. This illustrates the importance of a powerful extrinsic FVII dependent pathway to achieve hemostasis in the case of FVIII or FIX deficiency (hemophilia A and B).

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19

Matsumoto, Takeshi, Hideo Wada, Naoki Fujimoto, Junki Toyoda, Yasunori Abe, Kohshi Ohishi, Yoshiki Yamashita, et al. "An Evaluation of the Activated Partial Thromboplastin Time Waveform." Clinical and Applied Thrombosis/Hemostasis 24, no. 5 (September 8, 2017): 764–70. http://dx.doi.org/10.1177/1076029617724230.

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The activated partial thromboplastin time (APTT) waveform includes several parameters that are related to various underlying diseases. The APTT waveform was examined in various diseases. Regarding the pattern of APTT waveform, a biphasic pattern of the first or second derivative curve (DC) was observed in patients with hemophilia and patients positive for antiphospholipid (aPL) antibodies or coagulation factor VIII (FVIII) inhibitors. The time of the first and second DC and fibrin formation at 1/2 height were prolonged in patients with hemophilia, patients with inhibitors, patients positive for aPL, patients treated with anti-Xa agents, and patients with disseminated intravascular coagulation (DIC). These values all tended to decrease in pregnant women (at 28-36 weeks’ gestation). The height of the second derivative peak 1 was significantly lower in patients with hemophilia, patients with FVIII inhibitors, patients positive for aPL, patients treated with anti-Xa agents, and patients with DIC; these values tended to be significantly higher in pregnant women. The height of the first DC was significantly lower in patients who were positive for FVIII inhibitors and was significantly higher in patients treated with anti-Xa agents and pregnant women. The height of the first and second DC was useful for the analysis of hemophilia, FVIII inhibitor, and aPL.

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20

Kramer, Gary, and Basil A. Bradlow. "An Analysis of Duplicate Testing of Prothrombin Time and Activated Partial Thromboplastin Time Assays." American Journal of Clinical Pathology 95, no. 1 (January 1, 1991): 77–81. http://dx.doi.org/10.1093/ajcp/95.1.77.

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21

Schneider, Christian P., Martin K. Angele, and Wolfgang H. Hartl. "Activated partial thromboplastin time waveform analysis as specific sepsis marker in cardiopulmonary bypass surgery." Critical Care 14, no. 1 (2010): 104. http://dx.doi.org/10.1186/cc8226.

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22

Poller, Leon, Saied Ibrahim, Michelle Keown, Albert Pattison, and Jørgen Jespersen. "Simplified Method for International Normalized Ratio (INR) Derivation Based on the Prothrombin Time/INR Line: An International Study." Clinical Chemistry 56, no. 10 (October 1, 2010): 1608–17. http://dx.doi.org/10.1373/clinchem.2009.141937.

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BACKGROUND The need to perform local International Sensitivity Index (ISI) calibrations and in particular the requirement for a manual method for prothrombin time (PT) determination, have proved to be obstacles to application of the WHO scheme for PT standardization. METHODS We used international normalized ratio (INR) derived with a set of only 5 European Concerted Action on Anticoagulation (ECAA) lyophilized calibrant plasmas, certified manually by expert centers with reference thromboplastins, to determine a local PT/INR Line. We compared results of an independent set of validation plasmas with INRs from conventional ISI calibrations and with manually certified INRs. RESULTS The mean certified INR of 5 lyophilized validation plasmas was 2.41 with human thromboplastin, 2.04 with bovine/combined, and 2.80 with rabbit. With 42 human reagents, the mean observed INR of the validation plasmas was 2.68 (11.2% deviation from certified INR). Deviation was reduced to 0.4% with both local ISI calibration and the PT/INR Line. Eight results based on bovine/combined thromboplastin gave an INR deviation of 4.9%, becoming 0.5% after ISI calibration and 2.4% with the PT/INR Line. Six results with rabbit reagents deviated from certified INR by 2.5%. After ISI calibration, deviation became 1.1%, and with the PT/INR Line, 0.7%. The PT/INR Line gave similar results with both linear and orthogonal regression analysis. The total proportion of validation plasmas giving INR within 10% deviation from certified values was 42.5% with uncorrected INR, which increased to 92.1% with local ISI calibration and 93.2% with the PT/INR Line. CONCLUSIONS The PT/INR Line procedure with 5 ECAA calibrant plasmas successfully substitutes for local ISI calibrations in deriving reliable INRs.

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Harenberg, Job, Christina Giese, Svetlana Marx, and Roland Kraemer. "Determination of the International Sensitivity Index for Rivaroxaban Using the WHO RBT/90 Thromboplastin as a Calibrant for Other Thromboplastin Reagents." Blood 116, no. 21 (November 19, 2010): 1089. http://dx.doi.org/10.1182/blood.v116.21.1089.1089.

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Abstract Abstract 1089 Patients on treatment with vitamin-K-antagonists (VKA) are monitored by the international normalized ratio (INR). The international sensitivity index (ISI) standardizes the differences between prothrombin assays (PT) through a comparison with a WHO thromboplastin reagent. Rivaroxaban prolongs PT assays dose dependently. The steepness of these curves differs between the PT assays. PT assays have not been standardized for rivaroxaban using a WHO Thromboplastin reagent. Rivaroxaban was extracted from commercially available drug with dichloromethane. Identity and purity of the isolated compound were confirmed by mass spectrometry (exact mass 436,0734), elementary analysis (carbon, hydrogen, nitrogen content) and 1H-NMR spectroscopy. Pooled plasma from healthy persons was spiked with 25 ng/ml to 900 ng/ml rivaroxaban. Thromboplastin reagents were WHO RBT/90, neoplastinPlus, recombiplastin, innovin and thromborel. All assays were performed with the manual kolla-hook method and with the KC coagulometer. Increasing concentrations of rivaroxaban prolonged coagulation values of all PT assays linearly (coefficient of correlation between r=0.97 and r=0.99). The steepness of the dilution curves differed substantially between assays. Accordingly, the ratios for the rivaroxaban concentrations varied (ratio=PTriva(xi)/PTriva(i0)). The coefficient of variation CV of the ratios between methods ranged from 7% to 33%. The ISI for rivaroxaban was calculation for each method by x=(y-a)/b (x=ratio WHO-kolla hook manual method, y=ratio method new, a=intercept, b=steepness). The ISIRiva was 1 for the WHO reagent using the manual method and ranged from 0.94 to 1.67 for the other PT-methods compared to the WHO RBT/90 PT reagent. The equation INRriva=ratiorivaISIriva was used to calculate INRriva. The CVs of INRriva between methods decreased to 1.1% to 7.2% (mean 3.9%) as compared to the ratio without ISIRiva. The differences of the CV between TP-reagents were reduced to about 4% using the WHO RBT/90 thromboplastin reagent manual method as standard and an ISI for rivaroxaban. Disclosures: No relevant conflicts of interest to declare.

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Han, Yangsook, William B. Lawson, W. Jean Dodds, and Charles E. Lawrence. "Prothrombin Time Proficiency Testing: A Robust Grading Method." Thrombosis and Haemostasis 54, no. 03 (1985): 704–8. http://dx.doi.org/10.1055/s-0038-1660102.

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SummaryA robust two-way analysis of variance technique was applied to determine simultaneously the effects of method and thromboplastin on prothrombin time. A new approach to outlier detection for two-way analysis of variance was used. Focusing on the underlying error structure improved the uniformity of the grading procedure in the hematology proficiency testing program of the New York State Department of Health.The logarithm-transformed scale produced constancy of error variance and resulted in uniformity of the acceptable spread of data. The common variance was lower than that obtained by previous methods and allowed for a narrower acceptable range of reported prothrombin times by reducing the inflated standard deviation, thus improving the efficiency of the grading procedure.For proficiency testing, no advantage was found in the use of either a common thromboplastin or freeze-dried, coumadinized patient plasmas rather than artificially depleted commercial plasmas, except for special purposes.

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Tsuda, H., S. Higashi, S. Iwanaga, T. Kubota, T. Morita, and K. Yanaga. "Development of antitissue factor antibodies in patients after liver surgery." Blood 82, no. 1 (July 1, 1993): 96–102. http://dx.doi.org/10.1182/blood.v82.1.96.bloodjournal82196.

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After liver surgery, two patients developed unexplainable prolonged prothrombin times (PT) that were not associated with bleeding tendency. The substitution of rabbit thromboplastin for either human or monkey thromboplastin in performing PT tests resulted in a normal clotting time. Tissue factor (TF) procoagulant activity assays and an immunoblotting analysis showed that these patients had developed IgG lambda-type immediate anticoagulants directed against both rabbit and bovine TF that did not crossreact with human or monkey TF. In a chromogenic assay, the patient IgG caused a decrease in both the Km and the Vmax of the factor X activation by rabbit TF-factor VIIa complex. The lack of reactivity of the patient IgG with human TF presumably explained why there was no clinical bleeding. Both patients had been treated earlier with a topical hemostatic agent prepared from bovine corium, microfibrillar collagen hemostat, while undergoing previous surgery. In an immunoblotting analysis, the patient IgG stained a 42-Kd band in the Triton extract of the collagen preparation under either reducing or nonreducing conditions. The Triton extract of the collagen preparation blocked the binding of the patient IgG to bovine TF. Thus, it is suggested that the iatrogenic immunization by intraoperative exposure of bovine TF retained in the collagen preparation may be responsible for the development of anti-TF antibodies in these patients. The anti-TF antibodies resulted in a clinical error in the evaluation of coagulation status after the use of rabbit thromboplastin.

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Tragoulia, Eleftheria, Maria Ditsa, Poly Kazila, Chrisa Meleti, Anastasia Mpanti, Efi Yannaki, and Dimitra Markala. "C0138 Utilization of waveform analysis of activated partial thromboplastin time (APTT)- clinical and prognostic value." Thrombosis Research 130 (October 2012): S168. http://dx.doi.org/10.1016/j.thromres.2012.08.175.

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Paize, Fauzia, Enitan Carrol, Colin Downey, Christopher M. Parry, Gerwyn Green, Peter Diggle, Paul Newland, et al. "Diagnostic efficacy of activated partial thromboplastin time waveform and procalcitonin analysis in pediatric meningococcal sepsis." Pediatric Critical Care Medicine 12, no. 6 (November 2011): e322-e329. http://dx.doi.org/10.1097/pcc.0b013e3182231034.

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Andreasen, Jo Bønding, Anne-Mette Hvas, Kirsten Christiansen, and Hanne Berg Ravn. "Can RoTEM®analysis be applied for haemostatic monitoring in paediatric congenital heart surgery?" Cardiology in the Young 21, no. 6 (May 24, 2011): 684–91. http://dx.doi.org/10.1017/s1047951111000758.

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AbstractBackgroundSuccessful management of bleeding disorders after congenital heart surgery requires detection of specific coagulation disturbances. Whole-blood rotation thromboelastometry (RoTEM®) provides continuous qualitative haemostatic profiles, and the technique has shown promising results in adult cardiac surgery.SettingTo compare the performance of RoTEM®with that of conventional coagulation tests in children, we conducted a descriptive study in children undergoing congenital cardiac surgery. For that purpose, 60 children were enrolled and had blood samples taken before, immediately after, and 1 day after surgery. Conventional coagulation tests included: activated partial thromboplastin time, prothrombin time, fibrinogen, fibrin D-dimer, thrombin clotting time, factor XIII, and platelet count.ResultsPost-surgical haemostatic impairment was present to some degree in all children, as seen by pronounced changes in activated partial thromboplastin time, prothrombin time, thrombin clotting time, and platelet count, as well as RoTEM®analysis. RoTEM®showed marked changes in clotting time – prolonged by 7–18% – clot formation time – prolonged by 46–71% – maximum clot firmness – reduced by 10–19%, and maximum velocity – reduced by 29–39%. Comparison of the two techniques showed that conventional coagulation tests and RoTEM®performed equally well with regard to negative predictive values for excessive post-operative drain production – more than 20 millilitres per kilogram per 24 hours after surgery – with an area under the curve of approximately 0.65.ConclusionRoTEM®can detect haemostatic impairments in children undergoing cardiac surgery and the method should be considered as a supplement in the perioperative care of the children where targeted transfusion therapy is necessary to avoid volume overload.

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L. Venkatraman, Kalkooru, Azeemullah A. Syed, Parimelazhagan Indumathi, and Alka Mehta. "VITPOR AI, A Coagulation Factor XIIa Inhibitor from Porphyra yezoensis: In Vivo Mode of Action and Assessment of Platelet Function Analysis." Protein & Peptide Letters 27, no. 3 (February 10, 2020): 243–50. http://dx.doi.org/10.2174/0929866526666191026111056.

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Background: Thrombosis represents as the prime contributor to the burden of diseases, worldwide. Conventional anticoagulants for thrombosis therapy have a common bleeding side effect. Bioactive peptides are studied to be an effective alternative for currently available therapeutic drugs. Objective: In this study, VITPOR AI peptide, a previously reported coagulation FXIIa inhibitor from Nori (Porphyra yezoensis), was assessed for its inhibitory activity against FXIIa and its in vivo mode of action. Methods: In vivo efficacy as well as the antithrombotic property of the peptide was evaluated in mice model by ex vivo activated Partial Thromboplastin Time assay, tail transection model and whole blood clotting time. The enzyme kinetics was studied using chromogenic substrate assay. Results: The kinetic behaviour of VITPOR AI showed that the peptide is a competitive inhibitor of FXIIa. Peptide showed significant inhibition of platelet adhesion and aggregation. VITPOR AI exhibited significant antithrombotic activity. Furthermore, ex vivo activated Partial Thromboplastin Time assay revealed that VITPOR AI exhibited potent anticoagulant activity in vivo. Tail bleeding assay revealed that the peptide did not prolong bleeding time in mice even at a higher dose of 5 mg/kg. Cytotoxicity studies of the peptide against human blood leukocytes indicated the safety of the peptide. Conclusion: VITPOR AI could be prospected as a potent anticoagulant with Factor XIIa inhibition, antiplatelet aggregation and antithrombotic activity. It was also studied to have no bleeding side effect.

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Karim, Fayeza, Qazi Shamima Akter, Shamima Jahan, Afruza Khanom, Samira Haque, Tania Yeasmin, Tashfia Siddika, and Susmita Sinha. "Coagulation Impairment in Type 2 Diabetes Mellitus." Journal of Bangladesh Society of Physiologist 10, no. 1 (August 21, 2015): 26–29. http://dx.doi.org/10.3329/jbsp.v10i1.24614.

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Background: Complication of diabetes mellitus (DM) includes coagulation impairment. Hypercoagulable state in patient with DM may accelerate thromboembolic risk for cardiovascular disease (CVD).Objective: To assess Prothrombin Time and Activated Partial Thromboplastin Time in type 2 diabetes mellitus for observing their coagubility status.Methods: This cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka from July 2013 to June 2014. One hundred male patients with type 2 diabetes mellitus aged 40-60 years and one hundred age, BMI matched healthy subjects were included as control in this study. Patients were selected from BIRDEM, Dhaka. Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT) were estimated by auto analyzer. For statistical analysis unpaired studentt test was used.Results: In this study PT and APTT were significantly (P<0.001) lower in diabetes mellitus than those of control group.Conclusion: From this study, it may be concluded that diabetic patients are prone to develop coagulation impairment.Bangladesh Soc Physiol. 2015, June; 10(1): 26-29

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Poller, Leon, Saied Ibrahim, Albert Pattison, and Jørgen Jespersen. "INR derivation with the PT/INR Line simplified using a spreadsheet from the world wide web." Journal of Clinical Pathology 64, no. 10 (April 22, 2011): 930–32. http://dx.doi.org/10.1136/jclinpath-2011-200068.

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BackgroundThe prothrombin time/international normalised ratio (PT/INR) Line method to derive INR, based on only five European Concerted Action on Anticoagulation (ECAA) certified plasmas, is shown to be reliable in previous ECAA studies. A simpler method not requiring linear regression calculation would be an advantage.MethodAfter determining the local PT/INR Line, local INRs have been obtained using a readily available spreadsheet on the internet which laboratories can use without performing any additional calculations.ResultsExamples of INR derivation have been obtained from results at 16 centres using a range of local coagulometers with human thromboplastin international reference preparations (IRPs). The procedure does not require manual PT testing, local international sensitivity index calibration, availability of thromboplastin IRPs or local mean normal prothrombin time.ConclusionsFrom the PT/INR Line, INR values for local PT results are easily obtained using an Excel spreadsheet from our website (http://www.anticoagulants.co.uk/) which does not require the complex linear regression analysis to derive INR.

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Jaganathan, Saravana Kumar, Mohan Prasath Mani, Rajasekar Rathanasamy, and Praseetha Prabhakaran. "Fabrication and characterization of tailor-made novel electrospun fibrous polyurethane scaffolds decorated with propolis and neem oil for tissue engineering applications." Journal of Industrial Textiles 49, no. 9 (October 30, 2018): 1178–97. http://dx.doi.org/10.1177/1528083718808787.

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Recently, textile technologies have gained a huge attention for fabricating the tissue constructs. In tissue engineering, the development of biodegradable polymer scaffolds which resemble the native function of the extra cellular matrix is a great challenge. In this research, a novel electrospun scaffold based on polyurethane, propolis and neem oil was developed for tissue-engineering applications through textile technology like electrospinning. The morphology of the electrospun polyurethane/propolis and polyurethane/propolis/neem oil exhibited reduced fibre and pore diameter than the pristine polyurethane. The change in the chemical structure of the electrospun composites was identified by peak shifting of CH band peak with hydrogen bond formation.The contact angle measurements revealed that the PU/propolis mat was found to be super hydrophilic (0°) in nature and the electrospun polyurethane/propolis/neem oil mat was observed to be hydrophilic (41° ± 1) in nature. Thermogravimetric analysis and atomic force microscopy analysis showed that the prepared polyurethane/propolis and polyurethane/propolis/neem oil mats exhibited higher thermal stability and decreased surface roughness than the pristine polyurethane. Moreover, the developed polyurethane/propolis (activated partial thromboplastin time – 144 ± 4 s and prothrombin time – 85 ± 3 s) and polyurethane/propolis/neem oil (activated partial thromboplastin time – 147 ± 3 s and prothrombin time – 86 ± 2 s) composite displayed decreased blood clotting time than the pristine polyurethane (activated partial thromboplastin time – 153 ± 3 s and prothrombin time – 89 ± 3 s). The results of the haemolytic assay indicated that the electrospun polyurethane/propolis (1.21%) and polyurethane/propolis/neem oil (1.30%) mats exhibited better safety to red blood cells than the pristine polyurethane (2.48%). Hence, these desirable characteristics of the newly developed scaffold might be used as a potential platform for tissue engineering applications.

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Gils, Charlotte, Pernille Just Vinholt, and Mads Nybo. "Falsely prolonged activated partial thromboplastin time – a pre- and post-analytical issue." Biochemia medica 29, no. 1 (December 24, 2018): 157–61. http://dx.doi.org/10.11613/bm.2019.011001.

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This case highlights two common pre-analytical problems identified in routine coagulation testing of activated partial thromboplastin time (aPTT), which were overlooked because of a concurrent flag code indicating no coagulation and the result was replaced by asterisks. It concerns a boy with gastrointestinal bleeding and prolonged aPTT > 300 seconds, which raised the suspicion of haemophilia. When all other coagulation parameters (including specific coagulation factors VIII and IX) turned out to be normal, aPTT was re-measured using another analysis principle, which revealed a normal aPTT. The primary aPTT result turned out to be aborted due to concurrent haemolysis and lipaemia, but was erroneously interpreted as prolonged coagulation. The lesson is awareness of the possibility of numerous flag codes on the same sample overruling each other, and awareness on the responsibility in the post-analytical phase that must be carried by increased educational focus and by the manufacturers.

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Alamgeer, Qurat ul Ain, Umme Habiba Hasan, and Hira Asif. "Antithrombotic activity of Mentha longifolia in animal model." Bangladesh Journal of Pharmacology 13, no. 1 (March 5, 2018): 67. http://dx.doi.org/10.3329/bjp.v13i1.33243.

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<p class="Abstract">The present research work was conducted to appraise the antithrombotic activity of Mentha longifolia using in vitro and in vivo experiments. Aqueous methanolic (70:30) extract produced significant (p<0.01-0.001) and dose-dependent increase in in vitro blood clotting time, bleeding time, prothrombin time and activated partial thromboplastin level with maximum effect at highest concentration. While in in vivo experiment, aqueous methanol extract showed noteworthy (p<0.01-0.001) prolongation in bleeding time and clotting time after 30, 60 and 90 min of administration except for 25 mg/kg at 30 min which is non-significant. Moreover, plant extract exhibited considerable increase (p<0.1-0.001) in bleeding time, clotting time, prothrombin time as well as activated partial thromboplastin time in rabbits after seven days of treatment. Additionally, HPLC analysis of M. longifolia aqueous methanolic extract illustrated the presence of various valuable phytoconstituents. In a nutshell, M. longifolia possesses potential antithrombotic activity and hence systematically proved to be beneficial in patients with vascular diseases.</p>

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Kadiyala, Sri Ramulu, Karthik Rao, Nr Rao, Ram Bhat, Jayaprakash Rao, Navin Patil, and Balaji O. "ASSOCIATION OF POSTPRANDIAL BLOOD SUGAR WITH HYPERCOAGULABILITY IN COMPARISON TO FASTING BLOOD SUGARS IN DIABETIC AND HEALTHY PATIENTS: A CROSS-SECTIONAL STUDY." Asian Journal of Pharmaceutical and Clinical Research 10, no. 7 (July 1, 2017): 378. http://dx.doi.org/10.22159/ajpcr.2017.v10i7.18806.

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Objective: The aim of this study was to find the association of postprandial blood glucose with hypercoagulability in comparison to fasting blood sugars(FBS) in diabetic and healthy patients.Methods: The present study involved a total of 156 patients, of which 78 were taken as cases (diabetics) and other 78 as controls (non-diabetics). Laboratory analysis included prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen assay done along with fasting, and postprandial sugars.Results: Platelets in diabetics and healthy controls were in normal range. Decrease in PT and partial thromboplastin time was noted in diabetics compared to non-diabetic controls. Fibrinogen levels were increased in cases compared to controls. Changes in PT values were more significant with postprandial blood sugar (PPBS) levels when compared to FBS levels, and APTT follows the same pattern with more in PPBS levels and FBS levels in diabetics. PPBS showed elevated fibrinogen when compared to FBS in diabetics as well as non-diabetics.Conclusion: Type 2 diabetes mellitus is a hypercoagulable state as proven by the following results of our study.

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Jaganathan, Saravana Kumar, Mohan Prasath M, Ahmad Fauzi Ismail, Manikandan A, and Gomathi N. "Production and hemocompatibility assessment of novel electrospun polyurethane nanofibers loaded with dietary virgin coconut oil for vascular graft applications." Journal of Bioactive and Compatible Polymers 33, no. 2 (July 18, 2017): 210–23. http://dx.doi.org/10.1177/0883911517720815.

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To develop biodegradable polymer scaffolds suitable for vascular tissue engineering applications, the bioengineering community has invested an extensive effort. The most common cause for the failure of vascular graft scaffolds is thrombosis. In this work, the scaffold based on polyurethane and virgin coconut oil was produced by electrospinning process for vascular tissue engineering applications with improved antithrombogenicity. The diameter of this electrospun polyurethane/virgin coconut oil composite was found to be reduced in the range of 886 ± 207 nm compared to pristine polyurethane which was in the range of 969 ± 217 nm. The Fourier transform infrared spectroscopy analysis revealed the interaction between polyurethane and virgin coconut oil as indicated by phase shifting of CH bond along with the formation of hydrogen bond. The contact angle measurement of fabricated composites was found to be increased owing to hydrophobic nature and also exhibited enhanced thermal stability as noted in thermogravimetric analysis. The atomic force microscopy analysis insinuated the increased surface roughness of the composite in comparison with the pure polyurethane. Developed scaffold resulted in delayed blood clotting as revealed by activated partial thromboplastin time and partial thromboplastin time assay. The hemolytic index of fabricated composites was found to be low indicating the enhanced safety of red blood cells. Hence, the newly developed nanofibrous composite scaffold could open the door for a suitable alternative for vascular graft applications.

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Geng, Chuanying, Guangzhong Yang, Huijuan Wang, Zhiyao Zhang, Huixing Zhou, and Wenming Chen. "The Prognostic Role of Prothrombin Time and Activated Partial Thromboplastin Time in Patients with Newly Diagnosed Multiple Myeloma." BioMed Research International 2021 (May 19, 2021): 1–9. http://dx.doi.org/10.1155/2021/6689457.

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Purpose. To evaluate the prognostic role of prothrombin time (PT) and activated partial thromboplastin time (APTT) for newly diagnosed multiple myeloma (MM). Methods. We retrospectively analyzed 354 patients with newly diagnosed MM who received primary treatment in our center. The propensity score matching technique was used to reduce the bias between groups. Results. Among 354 patients, lengthened PT or APTT was observed in 154 (43.5%) patients and 200 (56.5%) patients had normal PT and APTT. Patients with lengthened PT or APTT had significantly shorter median overall survival (OS) (37.5 vs. 73.8 months, p < 0.001 ) and progression-free survival (PFS) (23.1 vs. 31.6 months, p = 0.001 ) than those with normal PT and APTT. Univariate Cox proportional hazards regression analyses showed that lengthened PT or APTT was associated with shorter OS ( HR = 2.100 , 95% CI: 1.525-2.893, p < 0.001 ). Lengthened PT or APTT was also a poor prognostic factor for OS ( HR = 3.183 , 95% CI: 1.803-5.617, p < 0.001 ) in multivariable analyses. The poor effect of lengthened PT or APTT on PFS was confirmed in univariate analysis ( HR = 1.715 , 95% CI: 1.244-2.365, p = 0.001 ), but it had no impact on PFS in multivariate analysis ( p = 0.197 ). In the propensity score matching analysis, 154 patients, 77 in each group, were identified. Among 154 matched patients, the OS of patients with lengthened PT or APTT was shorter (38.4 vs. 51.0 months, p = 0.030 ), but PFS was similar (29.0 vs. 35.0 months, p = 0.248 ). Conclusion. These results demonstrated that lengthened PT or APTT was an independent poor prognostic factor for patients with newly diagnosed MM.

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Wen Tan, Chuen, McVin Hua Heng Cheen, Heng Joo Ng, Lai Heng Lee, Sahul Hameed Ahamedulla, Brian Lee Wei Chua, Ian Qianhuang Wu, and Wan Hui Wong. "Elevated activated partial thromboplastin time-based clot waveform analysis markers have strong positive association with acute venous thromboembolism." Biochemia medica 29, no. 2 (April 14, 2019): 385–93. http://dx.doi.org/10.11613/bm.2019.020710.

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Introduction: A hypercoagulable state is a predisposition for venous thromboembolism (VTE). The activated partial thromboplastin time (aPTT)-based clot waveform analysis (CWA) is a global haemostatic measure but its role in assessment of hypercoagulability and thrombotic disorders is uncertain. We aimed to study the changes of CWA parameters in acute VTE. We hypothesized that patients with acute VTE would demonstrate higher CWA values than control patients without VTE and having elevated CWA parameters is associated with acute VTE. Materials and methods: Clot waveform analysis data from patients (N = 45) with objectively proven acute VTE who had an aPTT performed prior to initiation of anticoagulation were compared with controls (N = 111). The CWA parameters measured were min1, min2, max2 and delta change. Results: While the mean aPTT between VTE patients and controls did not differ (P = 0.830), the mean CWA parameters were significantly higher among VTE patients than controls (min1, P < 0.001; min2, P = 0.001; max2, P = 0.002; delta change, P < 0.001). There were significantly more cases within the VTE group exhibiting CWA values above their reference intervals than the control group (all P < 0.001), with the odds ratios for VTE of 8.0, 5.2, 4.8 and 18.6 for min1, min2, max2 and delta change, respectively (all P < 0.001). Conclusions: Patients with acute VTE had elevated aPTT-based CWA parameters than controls. Higher CWA parameters were significantly associated with acute VTE.

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Delannoy, Bertrand, Marie-Laurence Guye, Davy Slaiman, Jean-Jacques Lehot, and Maxime Cannesson. "Effect of cardiopulmonary bypass on activated partial thromboplastin time waveform analysis, serum procalcitonin and C-reactive protein concentrations." Critical Care 13, no. 6 (2009): R180. http://dx.doi.org/10.1186/cc8166.

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Liu, Jie, Fanfan Li, Kuangyi Shu, Tao Chen, Xiaoou Wang, Yaoqi Xie, Shanshan Li, Zhaohua Zhang, Susu Jin, and Minghua Jiang. "The analysis of false prolongation of the activated partial thromboplastin time (activator: silica): Interference of C-reactive protein." Journal of Clinical Laboratory Analysis 32, no. 8 (May 13, 2018): e22571. http://dx.doi.org/10.1002/jcla.22571.

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41

McGinnis, Eric, Steven K. W. Wong, and Tyler W. Smith. "Evaluation of activated partial thromboplastin time coagulation waveform analysis for identification of patients with acquired factor VIII inhibitors." International Journal of Laboratory Hematology 42, no. 4 (April 16, 2020): 411–17. http://dx.doi.org/10.1111/ijlh.13211.

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Beatriz, Moutinho, Pinto Beatriz, Cardoso Rita, Alves Helena, and Botelho Monica. "Effect of Pre-analytical Conditions on Prothrombin Time and Partial Activated Thromboplastin Time." Current Pharmaceutical Biotechnology 20, no. 4 (May 28, 2019): 327–31. http://dx.doi.org/10.2174/1389201020666190314125918.

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Background: Clinical analysis often involves clotting assays. Although the guidelines suggest the storing and freezing of samples before these assays, there are contradictory results in the literature. The objective of this study was to analyse the effect of the temperature and the storage of plasma sample on Prothrombin Time (PT) and Activated Partial Thromboplastin Time (aPTT) in clinical samples for 65 patients without coagulation disorders. Materials and Methods: After centrifugation, plasma of each patient was tested at arrival as part of their routine care and separately aliquoted. Three aliquots were stored at room temperature, 4°C and - 20°C for 24h after collection, two aliquots were stored at 4°C and -20°C for 1 week and one aliquot was stored at -70°C for 1 month. Results: PT from healthy patients was affected at room temperature for 24h and at 4°C for 1 week. For aPTT, the results were statistically different for all the conditions after 24h and at 4°C for 1 week. Conclusion: Results indicate that PT and aPTT can be stored at -70ºC for at least 1 month without any significant changes in the assay result.

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Ambreen, Sumaira, Muhammad Tariq, Muhammad S. Masoud, Imran Ali, Muhammad Qasim, Aamar Mushtaq, Maqsood Ahmed, and Rehana Asghar. "Anticoagulant potential and total phenolic content of six species of the genus Ficus from Azad Kashmir, Pakistan." Tropical Journal of Pharmaceutical Research 18, no. 6 (May 27, 2021): 1245–51. http://dx.doi.org/10.4314/tjpr.v18i6.14.

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Purpose: To investigate the total phenolic and flavonoid contents of Ficus benghalensis, Ficus elasticaa, Ficus palmata, Ficus religiosa, Ficus semicordata and Ficus auriculata, and to determine their anticoagulant potential. Methods: Crude methanol extracts were prepared from the plant leaves, and fractionated using liquidliquid partition with n-hexane, chloroform and ethyl acetate. The total flavonoid and total phenolic contents of the extracts and their fractions were determined. The anticoagulant potential of the six Ficus species were evaluated in healthy human plasma, using activated partial thromboplastin time (APTT) and prothrombin time (PT) methods. Results: Phytochemical analysis showed the presence of considerable amounts of flavonoids ranging from 5.3 ± 0.7 to 11.8 ± 0.3 mg rutin equivalents (RE)/g, and phenolic compounds ranging from 8.0 ± 0.7 to 86.5 ± 1.5 mg gallic acid equivalents (GAE)/g in each fraction of the six species. Results from in vitro anticoagulant potential assays showed significant anticoagulant properties, with prothrombin time (PT) ranging from 17.7 ± 0.7 to 26.7 ± 2.2 s, and activated partial thromboplastin time (APTT) varying from 47.7 ± 3.3 to 72.3 ± 5.4 s. Conclusion: The results indicate that F. semicordata and F. Religiosa have higher anticoagulant potential than the other Ficus species studied.

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Ritt, MG, KS Rogers, and JS Thomas. "Nephrotic syndrome resulting in thromboembolic disease and disseminated intravascular coagulation in a dog." Journal of the American Animal Hospital Association 33, no. 5 (September 1, 1997): 385–91. http://dx.doi.org/10.5326/15473317-33-5-385.

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Thromboembolic disease and progression to disseminated intravascular coagulation (DIC) are potential life-threatening complications for dogs with nephrotic syndrome. Platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), plasma concentration of fibrinogen degradation products (FDPs), antithrombin III (ATIII), protein C, and plasminogen were used to identify hemostatic abnormalities in a dog with nephrotic syndrome. Pulmonary thromboembolic disease was diagnosed by thoracic radiography, arterial blood gas analysis, and pulmonary scintigraphy. Prompt recognition and treatment of hemostatic complications is necessary in dogs with nephrotic syndrome.

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Golovko, L. S., A. V. Safronenko, E. V. Gantsgorn, N. V. Sukhorukova, and Y. S. Maklyakov. "Complex analysis of coagulation tests in patients undergoing the combination of hemostatic and antithrombotic therapy following large joint arthroplasty." Kazan medical journal 101, no. 4 (August 12, 2020): 489–500. http://dx.doi.org/10.17816/kmj2020-489.

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Aim. To assess the dynamics of coagulation parameters and the influence of its initial values on the development of postoperative thrombohemorrhagic complications in male and female patients undergoing large joint arthroplasty and received combination hemostatic and anticoagulant therapy. Methods. A retrospective analysis of the medical records (n=253) of patients with arthroplasty, were divided into two groups based on the time differences between prescription of hemostatic and anticoagulation therapy. The first group includes 145 patients (57.31%, 112 women and 33 men) with time differences 17 h, and the second group includes 108 patients (42.68%, 78 women and 30 men) with time differences 1824 h. The dynamics of coagulation test results were analyzed, and the influence of its initial value on the risk of postoperative thrombosis or bleeding was assessed. Results. Thrombohemorrhagic complications were recorded in 27 (10.67%) patients, of which 22 (81.48%) were observed in group 1. In the first group, thrombosis developed in regimens with tranexamic acid (p=0.038) with 2.2 times higher incidence than in group 2 (p=0.023). The risk of thrombosis of women in the group 1 was increased by an initially low level of international normalized ratio [relative risk (RR) 13.333, p=0.00032] and activated partial thromboplastin time (RR=5.8, p=0.037). The risk of bleeding in group 1 increased by an increasing preoperative level of activated partial thromboplastin time (RR=18, p=0.0012 and RR=28, p=0.00022, respectively) for all patients and by a decreasing fibrinogen level (RR=23.25, p=0.00065) and platelets count (RR=10.2, p=0.038) for women. Conclusion. To minimize the risks of thrombosis and bleeding after arthroplasty, especially in patients with initial deviations of hemostasis parameters from the norm, and, in particular, when using tranexamic acid as a hemostatic agent, it is recommended to observe the time interval between hemostatic and anticoagulant pharmacotherapy for at least 18 hours.

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Duan, Hong-Yong, Lin Ye, Xin Wu, Qiang Guan, Xiao-Fei Yang, Feng Han, Ning Liang, Zhen-Feng Wang, and Zhong-Gao Wang. "Thein vivocharacterization of electrospun heparin-bonded polycaprolactone in small-diameter vascular reconstruction." Vascular 23, no. 4 (September 10, 2014): 358–65. http://dx.doi.org/10.1177/1708538114550737.

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ObjectiveTo evaluate the possibility of using heparin-bonded polycaprolactone grafts to replace small-diameter arteries.MethodsPolycaprolactone was bonded with heparin. The activated partial thromboplastin time of heparin-bonded polycaprolactone grafts was determined in vitro. Small-diameter grafts were electrospun with heparin-bonded polycaprolactone and polycaprolactone and were implanted in dogs to substitute part of the femoral artery. Angiography was used to investigate the patency and aneurysm of the grafts after transplantation. After angiography, the patent grafts were explanted for histology analysis. The degradation of the grafts and the collagen content of the grafts were measured.ResultsActivated partial thromboplastin time tests in vitro showed that heparin-bonded polycaprolactone grafts exhibit obvious anticoagulation. Arteriography showed that two heparin-bonded polycaprolactone and three polycaprolactone grafts were obstructed. Other grafts were patent, without aneurysm formation. Histological analysis showed that the tested grafts degraded evidently over the implantation time and that the luminal surface of the tested grafts had become covered by endothelial cells. Collagen deposition in heparin-bonded polycaprolactone increased with time. There were no calcifications in the grafts. Gel permeation chromatography showed the heparin-bonded polycaprolactone explants at 12 weeks lose about 32% for Mw and 24% for Mn. The collagen content on the heparin-bonded polycaprolactone grafts increased over time.ConclusionThis preliminary study demonstrates that heparin-bonded polycaprolactone is a suitable graft for small artery reconstruction. However, heparin-bonded polycaprolactone degrades more rapidly than polycaprolactone in vivo.

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Almasy, Laura, Montserrat Borrell, William Stone, Francisco Blanco-Vaca, José Soria, John Blangero, Jordi Fontcuberta, and Juan Souto. "Thromboplastin-thrombomodulin-mediated Time and Serum Folate Levels Are Genetically Correlated with the Risk of Thromboembolic Disease: Results from the GAIT Project." Thrombosis and Haemostasis 87, no. 01 (2002): 68–73. http://dx.doi.org/10.1055/s-0037-1612945.

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SummaryThe GAIT (Genetic Analysis of Idiopathic Thrombophilia) Project is a family-based study dedicated to elucidating the genetic basis of hemostasis-related phenotypes and thrombosis risk. In this paper, we have examined several lesser-studied hemostasis-related phenotypes in the 21 GAIT families: levels of vitamin B12, serum folate, whole blood folate, α 2-antiplasmin, prekallikrein, β2-glycoprotein I, soluble P-selectin, factor XIII A and B subunits and a new coagulation measurement based on thromboplastin time in the presence or absence of thrombomodulin. Using the variance component method, we estimated the relative contributions of genetic and environmental influences on these phenotypes. In addition, we calculated the genetic correlations between thrombosis risk and each of these phenotypes.All 12 phenotypes showed significant genetic contributions with genes accounting for 22% to 78% of the variance after correction for covariate effects. Four phenotypes (three traits involving thromboplastin-thrombomodulin mediated coagulation time and serum folate) exhibited significant genetic correlations with thrombosis. Thus, some of the genes that influence quantitative variation in these physiological phenotypes also influence the risk of thrombosis.The high heritabilities and significant genetic correlations between thrombosis and some risk factors suggest that joint consideration of correlated quantitative phenotypes will aid in identifying susceptibility genes.

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Tang, Jia Ju, Jin Wang, Chang Jiang Pan, Ya Jun Weng, and Nan Huang. "Anticoagulation and Drug Release Behavior of Curcumin-Loaded PLGA Films." Key Engineering Materials 342-343 (July 2007): 481–84. http://dx.doi.org/10.4028/www.scientific.net/kem.342-343.481.

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Three kinds of curcumin-loaded films (3wt%, 5wt%, 8wt%) were prepared using poly(lactic acid-co-glycol acid (PLGA) as the carrier of curcumin, and studied. The result of Fourier transform infrared spectroscopy (FTIR) and X-ray electron spectroscopy (XPS) show that the curcumin is dispersed in the PLGA films. High performance liquid chromatography (HPLC) analysis suggests that the release of curcumin can last 22-43 days. A fewer number of adhered and activated platelets are observed on the curcumin-loaded PLGA films. The activated partial thromboplastin time (APTT) increases for all curcumin-loaded films.

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Petrovic, Miroljub, and Miodrag Rajic. "Biochemical alterations in patients with acute leukaemia." Jugoslovenska medicinska biohemija 21, no. 4 (2002): 351–54. http://dx.doi.org/10.2298/jmh0204351p.

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After statistical analysis of biochemical parameters in 60 patients with acute leukaemia, it was concluded that most prominent alterations were elevated values of serum lactate-dehydrogenase, uric acid and calcaemia. In patients with acute myeloid leukaemia, prothrombin time and partial thromboplastin time were significantly prolonged, and in patients with acute lymphocytic leukaemia serum immunoglobuline levels were significantly lower. Biochemical alterations may produce some implications for the general state of the patient, as well as for the clinical course of the disease, its complications and outcome, with possible influence on the effect of therapy.

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Budastra, I. N., B. N. P. Arhana, and IB Mudita. "Plasma prothrombin time and activated partial thromboplastin time as predictors of bleeding manifestations during dengue hemorrhagic fever." Paediatrica Indonesiana 49, no. 2 (April 30, 2009): 69. http://dx.doi.org/10.14238/pi49.2.2009.69-74.

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Background Massive bleeding and shock are complications ofdengue hemorrhagic fever (DHF) that are associated withhigh mortality. Impaired hemostasis, especially coagulopathy,contributes to bleeding manifestations in DHF. Parameters suchas activated partial thromboplastin time (APTT) and plasmaprothrombin time (PPT) indicate the impact of coagulationsystem.Objective To determine the relationship between APTT and PPTlevels with bleeding manifestations in DHF patients.Methods A prospective cohort study was applied to subjectsdiagnosed with DHF at the Infection and Tropical DiseasesDivision, Department of Child Health, Medical School, UdayanaUniversity, Sanglah Hospital, Denpasar, Indonesia. Laboratorytests to determine APTT and PPT were carried out on thethird, fourth, and fifth day after the onset of fever. Bleedingmanifestations were examined in patients during their hospitalstay. Univariate and Cox regression analyses were performedto examine relationship between APTT and PPT values withbleeding manifestations in DHF patients.Results Forty-three children were enrolled in this study. Therewas a significant relationship between increases in APTT valuewith bleeding manifestations in DHF patients [RR 2.79 (95%CI1.68 to 4.69), P <0.01]. Cox regression analysis showed that onlyincreased APTT values correlated with bleeding manifestations[RR 2.05 (95%CI 1.92 to 3.90), P = 0.02].Conclusion APTT values may be used as a predictor for bleedingmanifestations in DHF.

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