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Complete coagulation (APTT, PT, INR, fibrinogen)

Known as: Complete coagulogram
SKU: 283

36.90

Study material: Venous blood
Response time (working days): 1 ****
The test is done on an empty stomach: Yes
Home call service: No.
Country: Georgia

General Information

Coagulation Is an ongoing process in the body that prevents excessive bleeding. However, the circulating blood in your blood vessels should not normally clot. In the event of a clot and blood clot (s), a blood clot can travel through your bloodstream to the heart, lungs, or brain, causing a heart attack, stroke, or even death.

Coagulation tests determine the ability of a blood to clot and the time it takes to clot. Testing will help your doctor assess the risk of developing excessive bleeding or thrombosis.

 

When should we take the test?

aPTT

  • Control and monitoring of therapy with non-fractional heparin and thrombin inhibitors (hirudin, argatroban).
  • Diagnosis of congenital or acquired failure of certain coagulation factors (XII, XI, IX, VIII, VII), suspicion of hemophilia or von Willebrand disease.
  • Determine the presence of specific or nonspecific coagulation inhibitors (lupus anticoagulant, antiphospholipid antibodies).

PT

  • Evaluation of the activity of vitamin K-dependent coagulation factors.
  • Suspected congenital deficiency of coagulation factors (hereditary hemophilia and II, V, VII, X and fibrinogen factors).
  • Monitoring treatment with anticoagulants (syndrome, etc.).
  • Monitor liver function (assess its protein-producing function) and detect its abnormalities.
  • Eliminate blood clotting disorders before surgery or invasive procedures.
  • Suspicion of DIC syndrome (disseminated intravascular coagulation syndrome).
  • Suspicion of dysphibrinogenemia.
  • Suspicion of vitamin K deficiency.
  • When prone to bleeding (prolonged bleeding, frequent bleeding, bleeding from the nose and gums, spontaneous ecchymoses).
  • Venous thrombosis.

Fibrinogen

  • Suspicion of congenital or acquired fibrinogen deficiency.
  • Suspicion of excessive consumption of coagulation factors.
  • Monitoring of thrombolytic therapy.
  • Assess the risk of thrombotic complications, such as a heart attack or stroke in the presence of chronic heart disease.
  • Acute infections.
  • Frequent bleeding from the nose, gums, gastrointestinal tract, blood in the urine and / or stool.
  • Frequent bruises caused by minor trauma.
  • Bleeding for a long time and / or in case of abundant injury.
  • Blood clotting without adequate cause.
  • Evaluation of liver function.
  • You are taking blood thinner medications that are related to fibrinogen.
  • You have relatives with congenital disorders of blood clotting, fibrinogen.

It is advisable to perform the tests included in the complete coagulation profile:

  • For annual prophylactic examinations. The frequency of coagulation test for prophylaxis depends on the age of the patient: for young people it is recommended once a year, for the elderly - once every 6 months.
  • See also When infected with SARS-CoV-2, To prevent thrombosis.

The examination is prescribed by a doctor.

Possible interpretation of the results

aPTT

Prolongation of aPTT connected:

  • All congenital deficits (including hemophilia A and B, von Willebrand disease)
  • Thrombin inhibitors (hirudin, argatroban)
  • Streptokinase
  • Urokinase
  • Oral anticoagulant therapy
  • Vitamin K deficiency
  • Malnutrition
  • Intravascular coagulation syndrome
  • Existence of fibrin degradation products
  • Presence of circulating factor-specific anticoagulants
  • Nonspecific - Lupus anticoagulants
  • Normal PT (prothrombin time) prolonged aPTT: Deficiency of precalicine or one of the VIII, IX, XI and / or XII factors is likely.
  • Prolonged PT normal aPTT: A possible deficiency of factor VII is likely. Nutritional or therapeutic deficiency of vitamin K-dependent factors can sometimes lead to prolonged PT and normal aPTT.
  • Extended PT and aPTT: Deficiency of factor I, II, V or X is likely.

Reduction of aPTT connected:

  • Increased levels of one factor, most often factor VIII
  • Common neoplasms (except when the liver is damaged)
  • Acute bleeding
  • Early stage of DIC

A prolonged aPTT indicates hemorrhagic disease, and a decreased aPTT has been found to be an independent predictor of death in patients with a high risk of thrombosis and bleeding.

aPTT depends on the patient's age: in newborns, the upper limit of aPTT extends up to 55 seconds and gradually decreases to the values ​​typical for adults by 6 months; Prolonged aPTT values ​​in healthy children are caused by mild deficiencies of several coagulation proteins. In the elderly, aPTT may decrease.

PT

Prolongation of prothrombin means a delay in blood clotting and is manifested in the following cases:

  • Anticoagulant therapy.
  • Impaired liver function.
  • Insufficient amount of blood clotting proteins.
  • Vitamin K deficiency.
  • Deficiency of other coagulation factors (f. II, V, VII or X).
  • DIC syndrome.
  • Presence of blood clotting inhibitors.

Reduced prothrombin time means accelerated blood clotting and has no significant clinical significance. Manifested in the following cases:

  • Take vitamin K supplements.
  • Take large amounts of vitamin K products (green tea, liver, broccoli, soy).
  • Estrogen-containing drugs or hormone replacement therapy.

INR

The INR is evaluated in patients treated with oral anticoagulants and its determination serves to monitor dose and dose intervals.

Fibrinogen

Low levels of fibrinogen Can be found in the following cases:

  • Increased fibrinogen consumption in disseminated intravascular coagulation syndrome (DIC) and in case of excessive fibrin degradation in metastatic cancer, acute promyelocytic leukemia, obstetric complications.
  • Severe liver disease (decreased fibrinogen production).
  • Thrombolytic therapy.
  • L-asparaginase therapy.
  • Genetic diseases in the absence or deficiency of fibrinogen.
  • Moderate alcohol consumption.
  • The risk of bleeding during surgery is <50 mg / dL.

High levels of fibrinogen Can be found in the following cases:

  • Existence of systemic reaction of the organism to infections, inflammation, trauma, tumors, burns. In acute conditions, such as a heart attack or major surgery, fibrinogen levels return to normal after a critical period, on the other hand, in chronic inflammatory conditions (e.g., rheumatic and autoimmune diseases) fibrinogen levels remain high.
  • The body's compensatory response to protein loss from the kidneys during kidney disease and multiple myeloma.
  • Liver disease.
  • Estrogen treatment.
  • Hypertension, diabetes and overweight heart attack or stroke
  • With increased risk.

Additional information

Coagulation tests:

Activated partial thromboplastin time (aPTT)

The study of aPTT is a functional test that provides important information about the functioning of the coagulation system and certain factors.

This indicator is most commonly used to control and monitor therapy with non-fractional heparin and thrombin inhibitors (hirudin, argatroban). However, aPTT is not a first-line indicator when evaluating heparin treatment.

The test is also used to diagnose congenital or acquired insufficiency of certain coagulation factors (XII, XI, IX, VIII, VII) in case of suspected hemophilia or von Willebrand disease.

The aPTT test is used to detect the presence of specific or nonspecific coagulation inhibitors in the body - for example, lupus anticoagulant and antiphospholipid antibodies that are associated with clinical manifestations such as thrombosis.

It is also used as an indicator to assess the risk of bleeding before surgery.

Prothrombin time (PT)

Prothrombin is a protein synthesized by the liver and is one of the important factors that promotes blood clotting. Normal coagulation requires several types of proteins called coagulation factors. In the process of coagulation they must act properly and in sufficient quantities.

The assay determines the time (in seconds) during which a thrombus-producing protein called thrombin is produced from inactive prothrombin in the blood plasma taken for analysis.

It can detect both hypercoagulation and hypocoagulation.

PT is an important indicator of the condition of the coagulation system. It gives an idea of ​​the activity of the factors involved in the external coagulation pathway (VII, X, V, I, II). Factors VII, X, V, I, II are synthesized in the liver and the process requires the presence of vitamin K.

Prothrombin time is measured in seconds, but can be expressed in different ways: seconds (sec), prothrombin index in percent (%) and INR (International Normalized Ratio).

Prothrombin index - PI

Prothrombin activity in% is determined by analysis.

International Normalized Ratio (INR)

The analysis determines the relationship between prothrombin index (PI) and prothrombin time (PT).

It is comparable between different laboratories and according to its importance the doctor can determine the dose of prescribed anticoagulants and the interval between their reception.

INR is useful only in anticoagulant therapy and is not used to diagnose and treat patients with prolonged prothrombin time for other reasons.

Fibrinogen - Factor I.

Fibrinogen is an important protein in the coagulation cascade. It dissolves in plasma and platelet granules. In the last phase of blood clotting, fibrinogen is converted to an insoluble form - fibrin and participates in the formation of blood clots.

Fibrinogen is produced by the liver in the amount of 1,7 - 5 g per day. In addition to its role in the coagulation cascade, fibrinogen belongs to the group of acute phase proteins whose levels increase in the presence of a systemic response of the body to severe injury (trauma, extensive burns, infection, etc.).

How to prepare for the test?

Blood sampling is required for analysis Fasting, Without taking medication for the last 12 hours. The patient should be informed whether he or she is taking medications that affect blood clotting.

If you are taking blood thinners, Consult your doctor In connection with the examination.

If heparin therapy is required to be monitored, test material should be obtained from a non-heparinized source one hour prior to the next heparin administration.

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