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Several antithrombin drugs currently under clinical development for cardiovascular indications include argatroban, efegatran, hirudin, and polyethylene glycol (PEG)-hirudin. As with heparin, these patients are started on warfarin while still being treated with the antithrombin agents until an INR value of 2.5–3.5 is achieved. One problem seen in these patients is that the antithrombin agents interfere in the prothrombin time (PT) assay by inhibiting thrombin and preventing the formation of a fibrin clot, thus causing a falsely increased INR. Therefore, an alternative method is needed to reliably quantify the effect of oral anticoagulant drugs in patients simultaneously administered oral anticoagulants and antithrombin agents.Oral anticoagulants are known to influence the functional concentrations of the coagulation factors II, VII, IX, and X. Thus, a direct measure of any of these factors may be useful in predicting the extent …

Factor X Values as a Means to Assess the Extent of Oral Anticoagulation in Patients Receiving Antithrombin Drugs