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Related Experiment Videos

Comparison of two different ecarin clotting time methods.

Tivadar Fenyvesi1, Job Harenberg, Christel Weiss

  • 1IV. Department of Medicine, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim, Germany. j-harenberg@t-online.de

Journal of Thrombosis and Thrombolysis
|September 1, 2005
PubMed
Summary

The Ecarin Clotting Time (ECT) assay effectively monitors direct thrombin inhibitors (DTI) alongside vitamin K antagonists (VKA). While both ECT methods are suitable, additive effects of VKAs require consideration in clinical practice.

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Area of Science:

  • Hematology
  • Clinical Chemistry
  • Pharmacology

Background:

  • The Ecarin Clotting Time (ECT) assay measures direct thrombin inhibitor (DTI) activity.
  • Vitamin K antagonists (VKA) can prolong ECT, potentially affecting monitoring accuracy.
  • Concomitant VKA and DTI use may differentially impact established ECT methods.

Purpose of the Study:

  • To evaluate the suitability of two distinct ECT methods for monitoring DTIs in patients on VKA therapy.
  • To assess the influence of VKA on ECT results and the utility of the ECT ratio.

Main Methods:

  • Lepirudin, argatroban, and melagatran were added to normal plasma and warfarinized patient plasma.
  • Ecarin Clotting Time assays were performed using two different published methods.
  • Multifactorial variance analysis was used to analyze the data.

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Main Results:

  • Both ECT methods showed significant influence from DTIs, the method employed, and patient group (normal vs. VKA).
  • Normal ranges differed significantly between the two ECT methods and between normal and VKA plasma.
  • The ECT ratio demonstrated improvement but did not eliminate method-dependent differences.

Conclusions:

  • Both ECT methods are suitable for monitoring DTIs in patients concurrently treated with VKAs.
  • The ECT ratio offers some improvement in inter-method comparability but does not fully resolve discrepancies.
  • Additive effects of VKAs on ECT assays necessitate careful consideration in clinical settings.