Evaluation of protein C and protein S levels during oral anticoagulant therapy

Clin Lab Haematol. 1998 Aug;20(4):245-52. doi: 10.1046/j.1365-2257.1998.00130.x.

Abstract

A number of workers have examined protein C in relation to other vitamin K dependent factors during warfarin therapy and successfully identified protein C deficient patients by ratio calculation. However, protein S deficiency has not been addressed in this manner. This study compares protein C and protein S by functional and antigenic determination with procoagulant factors of similar half life (Factors VII and II) in an attempt to identify protein C and protein S deficient patients whilst on oral anticoagulant therapy. Procoagulant and anticoagulant factors were compared by linear regression in a population of normal blood donors and patients on stabilized warfarin therapy to obtain expected values for protein C and protein S dependent upon FVII and FII levels, respectively. Observed over expected values for protein C and protein S were calculated for individual patients and normal ranges derived. Comparison of similarly calculated observed over expected protein C and protein S ratios with these normal ranges successfully identified known protein C and protein S deficient patients who were taking warfarin at time of testing.

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anticoagulants / administration & dosage
  • Anticoagulants / therapeutic use*
  • Antigens / analysis
  • Factor VII / analysis
  • Female
  • Humans
  • International Normalized Ratio
  • Male
  • Middle Aged
  • Protein C / immunology
  • Protein C / metabolism*
  • Protein C Deficiency / blood
  • Protein C Deficiency / drug therapy
  • Protein S / immunology
  • Protein S / metabolism*
  • Protein S Deficiency / blood
  • Protein S Deficiency / drug therapy
  • Prothrombin / analysis
  • Reference Values
  • Thrombosis / drug therapy
  • Warfarin / administration & dosage
  • Warfarin / therapeutic use*

Substances

  • Anticoagulants
  • Antigens
  • Protein C
  • Protein S
  • Warfarin
  • Factor VII
  • Prothrombin