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Detection of protein C deficiency during oral anticoagulant therapy--use of the protein C:factor VII ratio.

Abstract
Laboratory diagnosis of protein C deficiency is complicated by the fact that many patients referred for investigation are already being treated with oral anticoagulants. Protein C and factor VII have similar half lives and by using the protein C:factor VII ratio we hoped to be able to detect protein C deficiency in patients receiving oral anticoagulants. We have studied activity levels of protein C and factor VII to produce protein C:factor VII activity ratios in 105 patients receiving oral anticoagulants, 42 normal subjects, and nine patients with known inherited protein C deficiency. The mean ratios for these groups were 1.38, 1.12 and 0.63 respectively. In patients receiving oral anticoagulants, the protein C level showed a poor correlation with the international normalized ratio (INR) value. Reference ranges for protein C at different levels of anticoagulation were therefore considered unsuitable for the identification of inherited protein C deficiency. Five patients with inherited protein C deficiency were studied with and without oral anticoagulation; their protein C:factor VII ratios remained relatively unchanged, despite alterations in the level of the individual proteins. These results suggest that measurement of the protein C:factor VII ratio may help to identify patients with inherited protein C deficiency whilst on oral anticoagulants.
AuthorsD W Jones, I J Mackie, M Winter, M Gallimore, S J Machin
JournalBlood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis (Blood Coagul Fibrinolysis) Vol. 2 Issue 3 Pg. 407-11 (Jun 1991) ISSN: 0957-5235 [Print] England
PMID1932526 (Publication Type: Journal Article)
Chemical References
  • Anticoagulants
  • Protein C
  • Factor VII
Topics
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anticoagulants (therapeutic use)
  • Factor VII (analysis)
  • Female
  • Humans
  • Male
  • Protein C (analysis)
  • Protein C Deficiency
  • Reference Values

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