[Control of oral anticoagulation. Current concepts]. 1989

C A Aguilar, and R Hurtado Monroy, and J Gaspar Hernández

The main objective of this short review is to bring into focus the most relevant of the recent advances in prothrombin time standardization and analyze the recommendations of the World Health Organization (WHO) for monitoring patients with thrombotic disorders under treatment with oral anticoagulant drugs. The prothrombin time (PT) is indicative of the proper therapeutic range in patients receiving oral anticoagulant drugs; however the reliability of the results will depend on the source and nature of the thromboplastin used. Different normal and therapeutic rangers are frequently observed when different brands of thromboplastin reagents and/or methods are used. The WHO, in conjunction with the International Committee of Thrombosis and Hemostasis and the International Committee of Standardization in Hematology, has recommended a calibration scheme for thromboplastin standardization with special reference for anticoagulant monitoring. Instead of reporting patient values, either in seconds or percent activity, WHO recommends the PT results in terms of an international normalized ratio (INR). This is obtained by formula: INR = RC in which R is the patient's PT and C is the international sensitivity index (ISI) of the thromboblastine employed. The INR represents the PT that would be obtained if it were performed with the WHO thromboplastin reference preparation. We suggest that these new concepts should be implemented by both laboratory and clinical professionals with the purpose of improving the effectiveness and safety of oral anticoagulation.

UI MeSH Term Description Entries
D007390 International Agencies International organizations which provide health-related or other cooperative services. Agencies, International,Agency, International,International Agency
D011517 Prothrombin Time Clotting time of PLASMA recalcified in the presence of excess TISSUE THROMBOPLASTIN. Factors measured are FIBRINOGEN; PROTHROMBIN; FACTOR V; FACTOR VII; and FACTOR X. It is used for monitoring anticoagulant therapy with COUMARINS. Quick Test,Russell's Viper Venom Time,Thrombotest,Russell Viper Venom Time,Russells Viper Venom Time,Prothrombin Times,Test, Quick,Time, Prothrombin,Times, Prothrombin
D012015 Reference Standards A basis of value established for the measure of quantity, weight, extent or quality, e.g. weight standards, standard solutions, methods, techniques, and procedures used in diagnosis and therapy. Standard Preparations,Standards, Reference,Preparations, Standard,Standardization,Standards,Preparation, Standard,Reference Standard,Standard Preparation,Standard, Reference
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000284 Administration, Oral The giving of drugs, chemicals, or other substances by mouth. Drug Administration, Oral,Administration, Oral Drug,Oral Administration,Oral Drug Administration,Administrations, Oral,Administrations, Oral Drug,Drug Administrations, Oral,Oral Administrations,Oral Drug Administrations
D000925 Anticoagulants Agents that prevent BLOOD CLOTTING. Anticoagulant Agent,Anticoagulant Drug,Anticoagulant,Anticoagulant Agents,Anticoagulant Drugs,Anticoagulation Agents,Indirect Thrombin Inhibitors,Agent, Anticoagulant,Agents, Anticoagulant,Agents, Anticoagulation,Drug, Anticoagulant,Drugs, Anticoagulant,Inhibitors, Indirect Thrombin,Thrombin Inhibitors, Indirect
D013925 Thromboplastin Constituent composed of protein and phospholipid that is widely distributed in many tissues. It serves as a cofactor with factor VIIa to activate factor X in the extrinsic pathway of blood coagulation. Antigens, CD142,CD142 Antigens,Coagulation Factor III,Factor III,Tissue Factor,Tissue Thromboplastin,Blood Coagulation Factor III,Coagulin,Glomerular Procoagulant Activity,Prothrombinase,Tissue Factor Procoagulant,Urothromboplastin,Activity, Glomerular Procoagulant,Factor III, Coagulation,Procoagulant Activity, Glomerular,Procoagulant, Tissue Factor,Thromboplastin, Tissue
D013927 Thrombosis Formation and development of a thrombus or blood clot in BLOOD VESSELS. Atherothrombosis,Thrombus,Blood Clot,Blood Clots,Thromboses

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