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Related Experiment Videos

Decrease in protein C antigen and formation of an abnormal protein soon after starting oral anticoagulant therapy.

S Viganò, P M Mannucci, S Solinas

    British Journal of Haematology
    |June 1, 1984
    PubMed
    Summary

    Warfarin therapy initially lowers protein C antigen (PC:Ag) similarly to factor VII, but an abnormal form with poor calcium binding emerges. This early PC reduction may impact anticoagulant therapy

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    Area of Science:

    • Biochemistry
    • Hematology
    • Pharmacology

    Background:

    • Oral anticoagulant therapy with warfarin is a common treatment for thrombotic disorders.
    • Protein C (PC) is a vitamin K-dependent anticoagulant protein.
    • The kinetics of PC antigen (PC:Ag) changes during warfarin initiation are not fully understood.

    Purpose of the Study:

    • To compare the changes in PC:Ag with other vitamin K-dependent factors (II, VII, IX, X) during warfarin therapy.
    • To investigate the characteristics of PC during the early phase of warfarin treatment.

    Main Methods:

    • Crossed immunoelectrophoresis was used to analyze protein C antigen.
    • Ten patients initiating warfarin therapy were monitored using thrombotest.
    • Measurements were taken at baseline and at various time points during the first 21 days of therapy.

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    Main Results:

    • PC:Ag decreased at a rate similar to factor VII:Ag between days 0 and 3 of warfarin therapy.
    • Factors II:Ag, IX:Ag, and X:Ag decreased at progressively slower rates than PC:Ag and VII:Ag.
    • An abnormal PC variant with impaired calcium-binding properties appeared early in warfarin treatment.

    Conclusions:

    • The rate of PC antigen decrease during early warfarin therapy more closely resembles that of factor VII than factors II, IX, or X.
    • The emergence of an abnormal, poorly calcium-binding PC variant suggests altered protein processing or function.
    • Early reduction in functional protein C may contribute to the limited antithrombotic efficacy observed in the initial days of anticoagulant therapy.