Year 2010 Vol. 18 No 3




Antithrombotic therapy is widely applied in the practice of surgeons to treat thromboembolic complications (TEC) and in their prophylaxis. The main groups of the medicinal preparations traditionally used in the treatment and prevention of thromboses are antiplatelet agents and anticoagulants (direct and indirect ones). Their own laboratory control methods correspond to each group of preparations.
Laboratory investigations are divided into two groups – methods which permit to determine the effect of the anticoagulant on functioning of the blood coagulation system and methods which estimate the efficacy of the antithrombotic effect – thrombinemia cupping.
The programs of the laboratory monitoring of the action of direct and indirect anticoagulants and antiplatelet agents are presented; the main laboratory tests and terms for their use are determined as well as the algorithms of the selection of the preparations’ dosage. Additional investigations while using heparins are found out as well as the investigation frequency of INR and APTT during therapy with warfarin. In such cases laboratory diagnostics is aimed at ensuring efficacy and safety of the antithrombotic therapy.
Patients taking warfarin are shown and they differ from each other in the period of induction and in the period of maintenance dose. The factors influencing the hyporcoagulation degree, INR result and its stability during therapy with indirect anticoagulants, indications for extraordinary investigation of INR are identified.

Keywords: thromboembolic complications, anticoagulant therapy, laboratory control
p. 150 – 161 of the original issue
  1. Вавилова, Т. В. Гемостазиология в клинической практике / Т. В. Вавилова. – СПб.: СПбГМУ им. акад. И.П. Павлова, 2005. – 92 с.
  2. Зубаиров, Д. М. Молекулярные основы свёртывания крови и тромбообразования / Д. М. Зубаиров. – Казань: Фэн, 2000. – 364 с.
  3. Момот, А. П. Патология гемостаза. Принципы и алгоритмы клинико-лабораторной диагностики / А. М. Момот. – СПб.: Форма Т, 2006. – 220 с.
  4. Панченко, Е. П. Профилактика тромбоэмболий у больных мерцательной аритмией / Е. П. Панченко, Е. С. Кропачева. – М.: ООО Медицинское информационное агентство, 2007. – 144 с.
  5. Российский Консенсус «Профилактика послеоперационных венозных тромбоэмболических осложнений». – М, 2000.
  6. Antithrombotic and Thrombolytic Therapy 8th Edition: ACCP Guidelines // Chest. 2008. – Vol. 133(6). – Р. 71S-109S.
  7. Baglin, T. P. Guidelines on oral anticoagulation (warfarin): third edition – 2005 update / T. P. Baglin, D. M. Keeling, H. G. Watson // British Society for Haematology 2005. – Vol. 132. – Р. 277–285.
  8. Bounameaux, H. Is laboratory monitoring of low molecular-weight heparin therapy necessary? No / H. Bounameaux, P. de Moerloose // J. Thromb. Haemost. – 2004. Vol. 2. – Р. 551-554.
  9. Favaloro, E. J. Clinical Utility of the PFA-100 / E. J. Favaloro // Semin Thromb Hemost. – 2008. – Vol. 34. – Р. 709–733.
  10. Gray, E. Heparin and low-molecular-weight heparin / E. Gray, B. Mulloy, T. Barrowcliffe // Thromb Haemost. – 2008. – Vol. 99. – Р. 807-818.
  11. Haubelt, H. Can Platelet Function Tests Predict the Clinical Efficacy of Aspirin? / H. Haubelt, C. Anders, P. Hellstern // Semin Thromb Hemost. – 2005. – Vol. 31(4). – Р. 404-410.
  12. Systematic Review: D-Dimer to Predict Recurrent Disease after Stopping Anticoagulant Therapy for Unprovoked Venous Thromboembolism / M. Verhovsek [et al.] // Ann. Intern. Med. 2008. – Vol. 149. – Р. 481-490.
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