Compositional differences in commercially available prothrombin complex concentrates

Prothrombin complex concentrates (PCCs) are used in the management of bleeding complications with conventional oral anticoagulant drugs. Since the activation of these complexes results in the generation of factor Xa and IIa, these agents may potentially neutralize the newly developed Xa and thrombin inhibitors. Although the potency of these agents is defined in units that represent the level of factor IX (FIX), other factors including factor II, VII, and X are also present. Protein C, protein S, and protein Z are also present. The purpose of this study is to compare the compositional differences in the currently available PCCs along with the older agents. Measurement of compositional parameters including protein and FIX, mass spectrometric analysis of the native and activated PCCs, Western blotting studies on the native and activated PCCs for the activation products including thrombin, and their effect on blood and plasma coagulation parameters were carried out.