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首页> 外文期刊>International journal of laboratory hematology >Preincubation in the prothrombinase-induced clotting time test (PiCT) is necessary for in vitro evaluation of fondaparinux and to be avoided for the reversible, direct factor Xa inhibitor, rivaroxaban
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Preincubation in the prothrombinase-induced clotting time test (PiCT) is necessary for in vitro evaluation of fondaparinux and to be avoided for the reversible, direct factor Xa inhibitor, rivaroxaban

机译：凝血酶原酶诱导的凝血时间测试（PiCT）中的预孵育对于磺达肝癸钠的体外评估是必要的，对于可逆的直接Xa抑制剂利伐沙班应避免

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Summary: Introduction: There is no clear consensus about tests in vitro that are suitable for evaluating various factor Xa inhibitors. The availability of reversible and irreversible inhibitors further complicates the application of available assays. Methods: We evaluated the suitability of the prothrombinase-induced clotting test (PiCT) for fondaparinux and rivaroxaban, as representatives for irreversible and reversible inhibition of factor Xa, with specific attention to preincubation times prior to re-calcification, in the context of automate program limitations. Results: We demonstrate that the PiCT assay requires a preincubation step to allow inhibitory activity by fondaparinux. Without this step, inhibition in the test is minimal and lacking sufficient dynamic range. In contrast, to measure the reversible inhibition by rivaroxaban, we found any preincubation introduced an artifact in inhibition as exemplified by a biphasic pattern and only the test without a preincubation phase gave informative results. Conclusion: It is concluded that PiCT in its format with two steps is suitable for fondaparinux evaluation, while its format without preincubation (the one-addition format) is suitable for reversible inhibitors such as rivaroxaban. Unfortunately, both types of inhibitors cannot be compared in vitro in a single assay format.
机译：摘要：简介：关于适用于评估各种Xa因子抑制剂的体外测试，尚无明确共识。可逆和不可逆抑制剂的可用性进一步使可用测定法的应用复杂化。方法：我们评估了凝血酶原酶诱导的凝血试验（PiCT）对磺达肝癸钠和利伐沙班的适应性，作为不可逆和可逆抑制因子Xa的代表，在自动化程序的背景下，特别注意重新钙化之前的预孵育时间局限性。结果：我们证明，PiCT分析需要预温育步骤才能使磺达肝癸钠具有抑制活性。如果没有此步骤，则测试中的抑制作用将很小，并且缺乏足够的动态范围。相比之下，为了测量利伐沙班的可逆抑制作用，我们发现任何预孵育都在抑制作用中引入了假象，例如双相模式，只有没有预孵育阶段的测试才能提供有益的结果。结论：结论：具有两步形式的PiCT适用于磺达肝癸钠评估，而无需预温育的形式（一加形式）适用于可逆抑制剂如利伐沙班。不幸的是，两种抑制剂都无法在单一测定形式下进行体外比较。

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