Indirect anticoagulants of the coumarin type have multiple effects on the blood coagulation mechanism. The activities of at least four different clotting factors are affected; only one of these is related exclusively to extravascular coagulation (factor VII), two act on the intraand extravascular coagulation mechanisms (prothrombin, Stuart-Prower factor), and one factor is involved in the intravascular mechanism only (factor IX). The one-stage prothrombin time (Quick) reflects the activity of the first three factors provided that the tissue thromboplastin used does not exhibit factor VII-like properties (1). The activity of factor IX makes no contribution to the one-stage prothrombin time. This test therefore does not fully indicate the changes induced during coumarin therapy. I n order to find a more adequate measurement of overall coagulability, several other tests have been investigated.The present study was designed to compare these different overall clotting tests and to investigate their interdependence on the activities of selectively determined clotting factors during coumarin therapy.The Quick one-stage prothrombin time test is widely accepted as the best available means of control of oral anticoagulant therapy. I t has been used throughout this study as a conimon point of comparison.
Experimental methods1. Collection of plasma: blood is collected from the subject directly into a 3.13 yo trisodium citrate (Na,C6H,0, 2H,O) solution with a V,A needle (9/1: V/V). The specimen is centrifuged for 6 minutes at 1,750 rpm.2 . Bleeding time: method of Duke-Elder (2). 3. Clotting time of venous blood: method of Lee and White (3). 4. RecalciJcatwn time (Howell time) : determination of the time interval between the addition of 0.1 ml of 0.05 M CaCl, to 0.2 ml plasma at 37" C and the appearance of a clot.
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