Thrombotic diseases and conditions – diagnosis and monitoring of anticoagulant therapy

Abstract

Laboratory methods are a very important part of the examination of patients with thrombotic diseases, often putting the final touches on the diagnosis, and in some cases even defining this diagnosis. The present review of thrombotic diseases and conditions, as well as the laboratory methods for their diagnosis, enables the differentiation of these conditions in the laboratory phase of the examination and the selection of the correct specific therapy, especially antithrombotic therapy.This review reflects the main nosological forms, causes of thrombotic diseases and conditions, as well as methods of their diagnosis using reagents and test systems of the leading domestic manufacturer of reagents for diagnostics of the hemostatic system SPD “Renam” ICPOD “Hemophilia Society”. The mechanisms of conditions and diseases such as deep vein thrombosis (DVT) and pulmonary artery thromboembolism (PATE), hypercoagulability syndrome (HCS), disseminated intravascular coagulation (DIC), hereditary and acquired thrombophilia (deficiency of antithrombin III, proteins C and S, factor Va resistance to activated protein C, etc.) and complications of anticoagulant therapy (heparin-induced thrombocytopenia (HITC), antiphospholipid syndrome (APS), complications of anticoagulant therapy (heparin-induced thrombocytopenia (HIT), coumarin-induced necrosis, etc.) are reviewed. Laboratory criteria for thrombotic conditions are presented. The most commonly used anticoagulant drugs and their control methods are reviewed, including vitamin K antagonists (oral anticoagulants, OAC), unfractionated heparin (UFH), low molecular weight heparins (LMWH), fondaparinux, direct or new oral anticoagulants (DOACs or NOACs). Laboratory criteria for thrombotic conditions are presented. Methods for determining blood D-dimer are described in detail, as well as methods for measuring anti-Xa and anti-IIa heparin activity.This joint work of the leading employees of the Research and Production Department «Renam» of ICPOD «Hemophilia Society» and FSBI NMRC of Hematology of the Ministry of Health of the Russian Federation reflects the need for scientific and practical cooperation of practitioners, laboratory doctors and manufacturers of reagents and test systems to develop the most sensitive, specific, accurate and convenient methods of disease diagnostics and control of therapy.