Changes of Normal Prothrombin Level(CA-1 Method) from the Start of Anticoagulant Therapy after Heart Surgery.

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  • KUDO Tatsuhiko
    Department of Cardiovascular Surgery. Hachioji Medical Center of Tokyo Medical University
  • TANAKA Asashi
    Department of Clinical Pathology, Hachioji Medical Center of Tokyo Medical University
  • YAMADA Daisuke
    Department of Biochemistry, Meiji Pharmaceutical University
  • MORITA Takashi
    Department of Biochemistry, Meiji Pharmaceutical University

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  • 心臓手術後の抗凝固療法開始早期における正常プロトロンビン量（ＣＡ‐１法）の変化

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Abstract

Normal prothrombin, i.e., fully γ-carboxylated prothrombin in plasma is now measurable by a chromogenic assay using carinactivase-1 (CA-1) isolated from the Echis carinatus leucogaster venom. This enzyme has been shown to solely activate fully γ-carboxylated prothrombin but not so-called PIVKA-II lacking one or more γ-carboxyglutamic acids in the prothrombin molecule. The plasma level of normal prothrombin was determined by the chromogenic assay utilizing this enzyme in 10 patients who had undergone heart surgery and had been treated with warfarin postoperatively. Plasma samples were collected from day 4 to day 20 after surgery and the data were compared with the values of thrombotest (TT) and the prothrombin time-international normalized ratio (PT-INR).<br>The level of normal prothrombin decreased in all patients after initiation of the warfarin therapy, and the extent of the decrease was found to correlate with TT positively, but with PT-INR negatively. Since the CA-1 method can be conducted very rapidly and requires only a small amount of plasma, this method is expected to be clinically utilized for monitoring the warfarin therapy after appropriate improvement in the assay system.

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