Effects of pentasaccharide (fondaparinux) and direct thrombin inhibitors on coagulation testing.

Archives of Pathology & Laboratory Medicine
Robert C GosselinJohn T Owings

Abstract

Direct thrombin inhibitors (DTIs) and fondaparinux represent a new class of anticoagulants. The effects of DTIs on activated partial thromboplastin time and prothrombin time measurements have been reported previously, but there are limited data on the impact of these anticoagulants on other coagulation tests. To determine the effects of fondaparinux and 3 DTIs (argatroban, bivalirudin, and lepirudin) on miscellaneous coagulation tests. Bivalirudin, lepirudin, argatroban, and fondaparinux were added to pooled normal plasma and tested for fibrinogen, antithrombin (thrombin and Xa substrate methods), plasminogen, protein C (clot and chromogenic methods), protein S, von Willebrand factor, D-dimer, lupus anticoagulant testing (dilute Russell viper venom test [DRVVT] with ratio), and factors II, IX, and X activities. We found no drug interference on antithrombin, plasminogen, chromogenic protein C, von Willebrand factor, or D-dimer results. All DTIs falsely decreased fibrinogen values, while falsely increasing protein C and protein S levels. All DTIs prolonged the DRVVT, and only argatroban yielded DRVVT ratios less than 1.2. Lepirudin demonstrated no effect on factor II activity, and only argatroban demonstrated decreased factor X a...Continue Reading

References

May 5, 1999·Lancet·J Hirsh, J I Weitz
Mar 16, 2002·The Annals of Pharmacotherapy·William E Dager, Richard H White
Jan 9, 2003·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Mahmut TobuJawed Fareed
May 22, 2003·Pathophysiology of Haemostasis and Thrombosis·T FenyvesiJ Harenberg
Jan 27, 2004·The Annals of Pharmacotherapy·Ashley S TraskWilliam E Dager

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Citations

Nov 2, 2006·Archives of Pathology & Laboratory Medicine·Agata SmogorzewskaElizabeth M Van Cott
Apr 26, 2006·Lupus·N Wiles, B J Hunt
Mar 23, 2005·Pediatric Blood & Cancer·Vinod V Balasa
Aug 9, 2005·Hematology·K H M Kuo, M J Kovacs
Nov 1, 2006·Critical Care Medicine·Lena M NapolitanoStanley A Nasraway
Jan 8, 2008·Pathologie-biologie·C Garcia HejlV Foissaud
May 27, 2008·Journal of Clinical Anesthesia·Alexander A VitinTiberiu Ezri
Apr 23, 2009·American Journal of Hematology·Kristi J Smock, George M Rodgers
Feb 5, 2010·American Journal of Hematology·Donna D Castellone, Elizabeth M Van Cott

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