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• Control of Oral Anticoagulant Therapy Using EDTA Plasma | ||
| Kerbala Journal of Medicine | ||
| Article 1, Volume 4, Issue 10, 2011, Pages 1122-1127 PDF (0 K) | ||
| Author | ||
| Israa M. Albayaa | ||
| Abstract | ||
| background: Prothrombin time test is traditionally used to monitor oral anticoagulant drugs given for various clinical conditions. Prothrombin time test is carried out on citrated plasma while most of the other hematological tests are carried on blood anticoagulated with Ethylenediamine tetra acetic acid (EDTA). Objective: To evaluate the possibility of using EDTA plasma for the control of oral anticoagulant drugs. Patients and methods: Thirty-six patients on different doses of Warfarin therapy were included in the study, and 21 normal healthy subjects were used as control group. The work was carried out in a private laboratory. Results were used to calculate the mean normal PT (MNPT) from both groups. Blood was withdrawn in 2 tubes: Citrate tube and EDTA tube. On each tube PT was determined in duplicate manually by Quick method using Biolabo thromboplastin reagents. For the patients group the international normalized ratio (INR) was calculated according to the thromboplastin manufacture kit instruction. SPSS version 9.0 was used to calculate the correlation and regression. MedCalc statistical program version 11.6.1.0 was used for assessing the clinical agreement using the Bland and Altman method. Results: A linear relationship between citrate and EDTA samples for the INR and PT estimations was observed. The regression equations for INR and PT estimations with citrate plasma (y) and EDTA plasma (x) were: INR citrate = (-0.4) + (1.25) INR EDTA, R2=0.97 PT citrate = (-3.14) + (0.89) PT EDTA, R2=0.96 Bland and Altman method was used to compare clinical difference of INR results of citrate and EDTA sample types which shows the mean difference (0.06) and the limits of agreement (0.46, -0.33) which represents the mean difference ± 1.96 SD. Only four measurements were out of range. Conclusion: Despite the very good correlation observed between results of citrate and EDTA samples, no clinical agreement was established between the two methods and the use of EDTA samples for performing PT tests by manual Quick method is not acceptable | ||
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