Ecarin Clotting Time

The determination of the Ecarin Clotting Time (ECT) is a method used in laboratory medicine to control the therapy of anticoagulation with direct thrombin inhibitors such as hirudin , dabigatran , argatroban and bivalirudin .

Test principle

The measurement is usually made from citrated blood . The measured variable is the clotting time in seconds. The test is based on the effect of Ecarin . It is a poisonous component of the snake common sand rattle otter ( Echis carinatus ). Ecarin is a metalloprotease that activates the coagulation factor prothrombin into meizothrombin . Thrombin and meizothrombin set the clotting process by splitting fibrinogen into fibringoing if they are not inhibited by thrombin inhibitors. The fibrinogen-activating effect of meizothrombin is less than that of thrombin. Like thrombin, meizothrombin is inhibited by the thrombin inhibitors. Depending on the concentration, the thrombin inhibitors are removed from the equilibrium, so that meizothrombin can initiate plasmatic coagulation. The clotting time is proportional to the concentration of the thrombin inhibitor.

Target ranges for the extension of the clotting time depend on the disease to be treated, the thrombin inhibitor used and the test system.

literature

• Hans D. Bruhn: Hemostaseology for Practice. Schattauer Verlag , 2011, ISBN 978-3794527359 , pp. 139-141.