OPTIMIZATION OF THE EVALUATION METHOD OF THE PERFORMANCE OF THERAPY USING INDIRECT ACTION ANTICOAGULANTS

Aim. Treatment by indirect anticoagulants (vitamin K antagonists) requires a personalized approach for controlling the overall level of prothrombin and the accumulation of its decarboxylated forms. The purpose of this work was to optimize the method for monitoring of the therapy with indirect anticoagulants. Methods. An analysis was performed of 41 blood plasma samples from patients with cardiovascula pathologies. Activated partial thromboplastin time (APTT), prothrombin time, ecamulin time, statistical data analysis (“Statistica 7”) have been used. Results. APTT test allowed identifying the individual sensitivity of patients to indirect anticoagulants. In particular, 20% of patients showed a decrease in the total level of prothrombin, which, together with the accumulation of decarboxylated forms, leads to a risk of bleeding. Individual insensitivity to the action of vitamin K antagonists was determined in 11% of patients. Conclusion. To control the efficacy of indirect anticoagulants therapy, we developed test in which ecamulin (protease from the venom of Echis multisquamatis) was used as a prothrombin activator, which can activate not only functionally active prothrombin, but also its decarboxylated forms. Use of ecamulin simultaneously with thromboplastin allows determining in the blood plasma the content of not only functionally active prothrombin, but also the total level of prothrombin, which makes it possible to control the accumulation of decarboxylated prothrombin.