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Thromb Haemost 1979; 42(04): 1296-1305
DOI: 10.1055/s-0038-1657025
Original Article
Schattauer GmbH Stuttgart

Spectrophotometric Assays of Prothrombin in Plasma of Patients Using Oral Anticoagulants

R M Bertina
The Hemostasis and Thrombosis Research Unit, Department of Medicine, University Hospital Leiden, Leiden, The Netherlands
,
W van der Marel-van Nieuwkoop
The Hemostasis and Thrombosis Research Unit, Department of Medicine, University Hospital Leiden, Leiden, The Netherlands
,
E A Loeliger
The Hemostasis and Thrombosis Research Unit, Department of Medicine, University Hospital Leiden, Leiden, The Netherlands
› Author Affiliations
Further Information

Publication History

Received 06 March 1979

Accepted 01 May 1979

Publication Date:
23 August 2018 (online)

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Summary

Two spectrophotometric assays for prothrombin have been developed and compared with a one stage coagulant and an immunological assay. One of these assays (called the XAPC assay) uses a combination of factor Xa, phospholipid, Ca2+ and factor V as activator of prothrombin, and measures only normal prothrombin. The second (the ECAR assay) uses Echis carinatus venom as activator. This assay measures both normal prothrombin and PIVKA II (protein induced by vitamin K antagonists/absence). Combination of the results obtained by the XAPC and ECAR assays provides rapid and reliable information on the degree of “subcarboxylation” of prothrombin (oral anticoagulation, vitamin K deficiency).

For patients on long term anticoagulant treatment the prothrombin time (Thrombotest) shows better correlation with the ratio prothrombin/prothrombin plus PIVKA II (XAPC/ ECAR) than with the factor II concentration. For patients starting the anticoagulant treatment there is no correlation between the Thrombotest time and the XAPC/ECAR ratio.

It seems doubtful that (a) spectrophotometric factor II assay(s) will be as useful as the prothrombin time in the control of oral anticoagulation.

 

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