Thromb Haemost 1984; 52(01): 042-044
DOI: 10.1055/s-0038-1661133
Original Article
Schattauer GmbH Stuttgart

Preoperative AT-III Values and Clinical Postoperative Thrombosis: A Comparison of Three Antithrombin-III Assays

Dona M Lynch
The Coagulation Laboratory, Department of Pathology, Rose Medical Center, Denver, Colorado, U.S.A.
,
Linda K Leff
The Coagulation Laboratory, Department of Pathology, Rose Medical Center, Denver, Colorado, U.S.A.
,
Stephen E Howe
The Coagulation Laboratory, Department of Pathology, Rose Medical Center, Denver, Colorado, U.S.A.
› Author Affiliations
Further Information

Publication History

Received 28 December 1983

Accepted 08 May 1984

Publication Date:
19 July 2018 (online)

Summary

Three antithrombin-III assays (Sigma functional plasma, von Kaulla functional serum, and Calbiochem-Behring radial immunodiffusion) are compared using preoperative serum and plasma from 48 patients admitted for cardiovascular or other major vascular surgery. Medical records were reviewed for evidence of thrombotic complications. Eight patients (17%) in this selected population had clinical evidence of postoperative thrombotic complications. The sensitivity and specificity for each AT-III assay were calculated, and the positive and negative predictive values in this population were determined. Sigma’s plasma AT-III had the highest positive predictive value (67%) and negative predictive value (100%). The functional serum and RID assays had significantly lower positive predictive values (23% and 38% respectively) and negative predictive values of 86%. Using the Two Sample t-Test to evaluate differences in AT- III values between the two patient groups, i.e., those who experienced thrombotic complications and those who did not, only the functional plasma AT-III method was statistically significant at a 95% confidence interval.

 
  • References

  • 1 Fareed J, Messraore HL, Wallenga JM, Bermes EW, Bick RL. Laboratory evaluation of antithrorabin-III: a critical overview of currently available methods for antithrombin-III measurements. Sem Thromb Hemostas 1982; 8: 288-301
  • 2 Seegers WH. Antithrombin-III. Theory and clinical applications. Am J Clin Pathol 1978; 69: 367-374
  • 3 Collen D, de Cock F. Thrombin-antithrombin III and plasminantiplasmin complexes as indicators of in vivo activation of coagulation and/or fibrinolytic systems. Thromb Haemostas 1977; 38: 173 (Abstr.)
  • 4 Cosgriff TM, Hershgold EJ, Martin BA, Carlson KS. False assignment of familial antithrombin III deficiency with the von Kaulla assay. Am J Clin Pathol 1983; 80: 697-699
  • 5 Nilsen DW, Jeremic M, Weisert OK, Fonstelien E, Godal HC. Functional and antigenic antithrombin III values in plasma and sera from 115 regular blood donors and antithrombin III in prediction of postoperative thrombosis. Thromb Haemostas 1983; 50: 530-533
  • 6 Sagar S, Stamatakis JD, Thomas DP, Kakkar VV. Oral contraceptives, antithrombin-III activity, and postoperative deep vein thrombosis. Lancet 1976; 1: 509-511
  • 7 von Kaulla E, von Kaulla KN. Deficiency of antithrombin-III activity associated with hereditary thrombosis tendeny. J Med 1972; 3: 309
  • 8 Egeberg O. Inherited antithrombin deficiency causing thrombophilia. Thrombos Diathes Haemorrh 1965; 13: 516-530
  • 9 Howie PW, Mallinson AC, Prentice CR M, Horne CW H, McNicol GP. Effect of combined oestrogen-progestogen oral contraceptives oestrogen-progestogen on antiplasma and antithrombin activity. Lancet 1970; 2: 1329-1332
  • 10 Prellwitz W, Schmitt K-F, Machner M, Schuster C-J, Weilemann L. Automated methods for plasma antithrombin III compared and the significance of the results. Clin Chem 1982; 28: 2249-2253
  • 11 Abildgaard U, Gravem K, Godal HC. Assay of progressive antithrombin in plasma. Thrombos Diathes Haemorrh 1970; 24: 224-229
  • 12 Bick RL, Kovacs I, Fekete LF. A new two-stage functional assay for antithrombin-III (Heparin Cofactor): clinical and laboratory evaluation. Thromb Res 1976; 8: 745-756
  • 13 Chockley M, Penner JA. An improved clinical assay for antithrombin- III. Am J Clin Pathol 1980; 74: 213-217
  • 14 von KaullaE, von KaullaK. Antithrombin-III and disease. Am J Clin Pathol 1967; 48: 69-80
  • 15 Fagerhol MK, Abildgaard U. Immunological studies in human AT- III. Influence of age, sex, and use of oral contraceptives on serum concentration. Scand J Haematol 1970; 7: 10-17
  • 16 Philo RD, Gaffney PJ. Comparison of antithrombin III assays using biological and chromogenic substrates. Br J Haematol 1982; 50: 147-156
  • 17 Odegard OR, Abildgaard U. Antithrombin III: critical review of assay methods. Significance of variations in health and disease Haemostasis 1978; 7: 127-134
  • 18 Hathaway WE, Assmus SL, Montgomery RR, Dubansky AS. Activated partial thromboplastin time and minor coagulopathies. Am J Clin Pathol 1979; 71: 22-25
  • 19 von Kaulla KN, von Kaulla E. The changing kinetics of blood coagulation in kidney and liver transplantation in man. Proceedings of the International Congress of International Medicine. Amsterdam: 1966. pp 126-131
  • 20 Sigma Technical Bulletin No. 855: Antithrombin-III (AT-III) in plasma. St. Louis, Sigma Chemical Company; 1979
  • 21 Calbiochem-Behring Technical Bulletin; M-Partigen Antithrombin- III. La Jolla, Calbiochem-Behring Company; 1981
  • 22 Rosner B. Fundamentals of Biostatistics. Duxbury, Boston, Press; 1982. pp 55-60
  • 23 Murano G. Antithrombin-III and its utilization during conversion of human plasma to serum in vitro. Thromb Haemostas 1983; 50: 120 (Abstr.)