Monitoring Therapy with Vitamin K Antagonists in Patients with Lupus Anticoagulant: Effect on Different Tests for INR Determination

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• 作者：Nick R. Bijsterveld ; Saskia Middeldorp ; Fenny Berends and Harry R. B¨¹ller
• 关键词：lupus anticoagulant ; antiphospholipid antibodies ; warfarin ; INR
• 刊名：Journal of Thrombosis and Thrombolysis
• 出版年：2000
• 出版时间：2000
• 年：2000
• 卷：9
• 期：3
• 页码：263-269
• 全文大小：115 KB

文摘

Background: Lupus anticoagulant (antiphospholipid antibodies) is associated with venous and arterial thrombosis in patients with and without autoimmune disorders. Vitamin K antagonists are the treatment of choice in patients with thrombosis, of which the dose is titrated by INR monitoring. Several recent reports suggest that the presence of the lupus anticoagulant disturbs the INR test and may lead to unreliable results with a large variation in INR values, dependent on the reagents used.Methods: We studied 11 lupus anticoagulant positive patients and 11 lupus anticoagulant negative patients, all using vitamin K antagonists. The INR value was determined using seven different tests and the variation in INR values was compared between the two groups. The amidolytic Factor X levels were used as an phospholipid independent measure for intensity of warfarin therapy. Factor VII and X activity were measured to assess the stability of warfarin therapy.