Document Detail

Levels of vitamin K-dependent procoagulant and anticoagulant proteins in over-anticoagulated patients.
MedLine Citation:
PMID:  12441913     Owner:  NLM     Status:  MEDLINE    
Coumarin anticoagulants impair the biological activity of the vitamin K-dependent procoagulant and anticoagulant proteins. There are no reports that focus on the levels of these proteins in over-anticoagulated patients. Therefore, we determined the levels of factor II, factor VII, factor IX and factor X, protein C and protein S in 25 randomly selected over-anticoagulated patients (International Normalized Ratio >/= 6.0) and in 25 matched, therapeutically anticoagulated patients with an International Normalized Ratio within the therapeutic zone. Furthermore, to study a possible effect of the cause of over-anticoagulation, coagulant levels were compared between 16 over-anticoagulated patients with fever in the preceding 2 weeks and 24 over-anticoagulated patients with stable congestive heart failure. The pattern of procoagulant level reductions in the three groups of over-anticoagulated patients was largely the same as in therapeutically anticoagulated patients: factor X was the lowest and factor IX the highest. The difference was that, in over-anticoagulated patients, factor VII was relatively low among the procoagulant factors compared with therapeutically anticoagulated patients. Protein C was lower than protein S in over-anticoagulated patients with congestive heart failure, but was similar to protein S in the other study groups. In over-anticoagulated patients with fever, the vitamin K-dependent coagulation proteins except factor X were significantly lower than in over-anticoagulated patients with congestive heart failure, especially factor VII and protein S.
F J Penning-van Beest; E B Gómez García; F J van der Meer; E van Meegen; F R Rosendaal; B H Stricker
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis     Volume:  13     ISSN:  0957-5235     ISO Abbreviation:  Blood Coagul. Fibrinolysis     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-11-20     Completed Date:  2003-10-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9102551     Medline TA:  Blood Coagul Fibrinolysis     Country:  England    
Other Details:
Languages:  eng     Pagination:  733-9     Citation Subset:  IM    
Pharmaco-Epidemiology Unit, Department of Internal Medicine and Epidemiology & Biostatistics, Erasmus University Medical Center Rotterdam, The Netherlands.
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MeSH Terms
Aged, 80 and over
Anticoagulants / blood,  pharmacology*
Blood Coagulation Factor Inhibitors / analysis*
Blood Coagulation Factors / analysis*,  drug effects
Case-Control Studies
Coumarins / blood,  pharmacology
Fever / blood
Heart Failure / blood
International Normalized Ratio
Middle Aged
Prospective Studies
Vitamin K
Reg. No./Substance:
0/Anticoagulants; 0/Blood Coagulation Factor Inhibitors; 0/Blood Coagulation Factors; 0/Coumarins; 12001-79-5/Vitamin K

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