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Comparison of Two Different Ecarin Clotting Time Methods

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Abstract

Background: Ecarin Clotting Time (ECT) assay specifically determines the inhibition of meizothrombin by direct thrombin inhibitors (DTI). Blood coagulation factor levels lowered by vitamin K antagonists (VKA) may prolong ECT. Concomitant treatment of VKA with DTI may influence differently the two published ECT methods.

Methods: Lepirudin (100–3000 ng/ml), argatroban (300–3000 ng/ml) and melagatran (30–1000 ng/ml) were added to normal plasma (NP; n = 12) samples and to plasma of patients on stable vitamin K antagonist therapy with warfarin (VKAP; n = 12). ECT assays were performed according to [5] (method 1) and according to [6] (method 2). Data were subjected to multifactorial variance analysis.

Results: Normal ranges were 35.5 ± 2.8 s in NP versus 31.8 ± 1.2 s in VKAP with method 1 (p < 0.001) and 44.3 ± 3.9 s in NP vs. 51.4 ± 8.3 s in VKAP with method 2 (p < 0.004). Besides the inhibitors (p < 0.0001), the method used (p < 0.0001) and the group (NP vs. VKAP, p = 0.003) had an influence on the ECT. Inhibitors (p < 0.02) or method used (p < 0.03) and the group (NP vs. VKAP, p = 0.0001) influenced also the ECT ratio.

Discussion: Both ECT methods are suitable for monitoring different DTIs over a large linear range with both methods during concomitant treatments with vitamin K antagonists. The ECT ratio improves but not abolishes the differences between the methods. Additive effects of vitamin K antagonists on ECT methods have to be taken into consideration in clinical routine.

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Authors and Affiliations

  1. IV. Department of Medicine, University Hospital Mannheim, Theodor-Kutzer-Ufer 1–3, D-68167, Mannheim, Germany

    Tivadar Fenyvesi, Job Harenberg (Prof. Dr. med.) & Ingrid Jörg

  2. Institute for Biometry and Medical Statistics, University Hospital, Theodor Kutzer Ufer 1–3, D-68167, Mannheim, Germany

    Christel Weiss

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  1. Tivadar Fenyvesi
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  2. Job Harenberg
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  3. Christel Weiss
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  4. Ingrid Jörg
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Correspondence to Job Harenberg.

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Fenyvesi, T., Harenberg, J., Weiss, C. et al. Comparison of Two Different Ecarin Clotting Time Methods. J Thromb Thrombolysis 20, 51–56 (2005). https://doi.org/10.1007/s11239-005-2925-x

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