2013
DOI: 10.5858/arpa.2012-0236-oa
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Direct Thrombin Inhibitors and Factor Xa Inhibitors Can Influence the Diluted Prothrombin Time Used as the Initial Screen for Lupus Anticoagulant

Abstract: Here we provide evidence that both the direct thrombin and indirect factor Xa inhibitors influence dPT assay for LA, causing false positivity. This should be considered when interpreting LA results during anticoagulant therapy. However, dPT seems to be a reliable test for LA screening under enoxaparin therapy after neutralization by heparinase.

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Cited by 10 publications
(10 citation statements)
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“…6). From the basic assays of APTT and PT [74] to the reduced degree of activation to improve sensitivity [75], which became particularly important in the thrombin generation assay [76].…”
Section: Hierarchy Of Experimental Models Of Hemostasismentioning
confidence: 99%
“…6). From the basic assays of APTT and PT [74] to the reduced degree of activation to improve sensitivity [75], which became particularly important in the thrombin generation assay [76].…”
Section: Hierarchy Of Experimental Models Of Hemostasismentioning
confidence: 99%
“…Low molecular weight heparins (LMWH) are generally considered to have little or no effect on standard prothrombin time and APTT assays yet dose, LMWH type and reagent variability can generate elevated clotting times [78,79]. Although interference of LMWH in LA assays is less frequent than with some other anticoagulants it does occur and the presence of LMWH must be taken into account when interpreting LA assays, even in reagents with heparin neutralisers [6,62,80].…”
Section: Testing Anticoagulated Patientsmentioning
confidence: 99%
“…The direct oral anticoagulants (DOAC) inevitably complicate LA testing and interpretation, and data continue to emerge concerning their effects on different LA assays [62,80,81,82,83,84]. Numerous studies have reported greater elevation of dRVVT screen values than confirm values with direct factor Xa (DFXa) inhibitors in non-LA patients or spiked NPP [26,62,81,83,84,85,86,87].…”
Section: Testing Anticoagulated Patientsmentioning
confidence: 99%
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“…For UFH, a three‐step procedure can exclude false‐positive screening results, and false positives due to LMWH occur only at supratherapeutic concentrations 18 . These interferences can be overcome by the use of heparin neutralizers when these medications are present below the threshold recommended by the manufacturer, which are commonly included in dRVVT but not aPTT reagents 19,20 . Factor deficiency in the setting of VKA therapy can be complemented by mixing 3 however, this can produce false negatives in the setting of a weak LAC, 21 as well as false positives depending on the reagents used 22 .…”
Section: Introductionmentioning
confidence: 99%