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Reference & control plasmas

Order number Description Quantity Delivery time CE
TB T5101 TriniCAL INR & Quick Calibrator Set 1x4 levels x 1 ml 15-20 days x

TriniCAL INR & Quick Calibrator Set

Monitoring of coumadin or coumadin-like Oral Anticoagulant Therapy (OAT) is generally performed with the Prothrombin Time (PT) test. When used for monitoring OAT, the World Health Organization recommends normalizing and reporting the results of the PT test as an INR rather than seconds. The PT may also be reported in a normalized format as a Percent Activity.

TriniCAL INR & Quick Calibrator Set may be used to:
1. Determine the patient’s INR directly by establishing an INR calibration curve.
2. Determine the patient’s Percent Activity directly by establishing a Percent Activity curve.
3. Determine a local ISI value of the measurement reagent/instrument system used in the PT test.

Coumadin or coumadin-like oral anticoagulant drugs reduce the activity of the vitamin-K dependent clotting factors II, VII, IX, X, Protein C, Protein S, and Protein Z. Coumadin induced reductions in factors II, VII, and X prolong the PT test.

PT test results can vary due to differences in the thromboplastin reagent and end-point detection method. The ISI/INR reporting system was developed under the auspices of the WHO as a method to normalize PT results. The INR is calculated as the ratio of the patient PT compared to the Mean Normal Prothrombin Time (MNPT) established in each laboratory, then raised to the power of the system specific ISI of the commercial thromboplastin/instrument used in the assay. The ISI is a measure of the sensitivity of the thromboplastin/instrument system to coumadin-induced deficiencies in the extrinsic pathway of coagulation, and is established by calibration to a recognized International Reference Preparation thromboplastin. Recent publications indicate the use of calibrant plasmas may improve accuracy of the local ISI, and thus improve and simplify the determination of INRs.

A second widely used method of normalizing the PT is the Percent Activity system. In this system dilutions of Pooled Normal Plasma (PNP) in saline or buffer are prepared, the PT clotting time of each dilution is measured, and a standard curve relating the reciprocal concentration of PNP to the clotting time is determined (1/% PNP versus PT). The patient Percent Activity is then read directly from this curve.



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