ABSTRACT
We evaluated several molecular markers of hemostasis in 92 patients with hypercoagulable
states treated with anticoagulant therapy. In all patients, the average values of
the international normalized ratio (INR) were 1.70 ± 0.50; this increase in INR was
not, however, significant in patients under thrombotest (TT) monitoring. There were
no thrombotic or severe bleeding complications in these patients during a period of
27 months. Plasma levels of thrombin-antithrombin complex (TAT), plasmin-plasmin inhibitor
complex (PPIC), D-dimer, and soluble fibrin monomer (sFM) were slightly increased,
suggesting that anticoagulant therapy was not completely effective in our Japanese
patients based on the values of the TT. The INR was negatively correlated with TT,
protein C, and protein S and particularly with TT between 10 and 80%. The range of
TT was not correlated with the plasma level of TAT, PPIC, D-dimer, or sFM, but the
range of INR was correlated with the plasma level of TAT, D-dimer, and sFM. The percentage
of TAT, D-dimer, and sFM within normal range was significantly lower in patients with
high INR. These findings show that INR is better than TT for the monitoring of warfarin
therapy and that the therapeutic values of INR during the anticoagulant therapy should
be > 1.7 in Japanese patients.
KEYWORD
D-dimer - anticoagulant therapy - INR - thrombotest