Test Code 62870832 Antithrombin III Activity
Performing Laboratory
Torrance Memorial Laboratories
Specimen Requirements
Specimen Type: Whole blood
Container/Tube: Blue top (citrate)
Specimen Volume: Tube must be filled
Collection Instructions:
1. Tube must be filled to the fill line.
2. If using butterfly, discard tube must be drawn first.
3. Acceptable: 1.8 mL Citrate Blue top or 2.7 mL Citrate Blue top
Additional Instructions:
1. Patient should be fasting, if possible
2. For certain tests, the patient cannot be
receiving the following anticoagulant medications:
- Heparin
- Warfarin/Coumadin
- Direct thrombin inhibitor: Pradaxa (dabigatran), Acova (argatroban)
- Direct Xa inhibitor: Xarelto (rivaroxaban), Eliquis (apixaban), Savaysa (edoxaban)
- tPA (tissue plasmin activator)
Specimen Transport Temperature
Ambient
Storage Temp Stability:
Room Temperature: 4 hours, unopened tube with plasma on cells, spun
or unspun
Refrigerated: 4 hours, unopened tube with plasma on cells,
spun or unspun
Frozen: 2 weeks (frozen plasma at -20 C)
Methodology
Chromogenic
Reference Range
>18 years: 80-130%
Interpretive Data
Antithrombin deficiencies due to inherited causes are much less common than those due to acquired causes.
Diagnosis of hereditary deficiency requires clinical correlation, with the prospect of repeat testing (including antithrombin antigen assay), and family studies (with appropriate counseling). DNA-based diagnostic testing may be helpful.
The clinical significance (thrombotic risk) of acquired antithrombin deficiency is not well established, but accumulating information suggests possible benefit of antithrombin replacement therapy in carefully selected situations.
Antithrombin deficiency, acquired or congenital, may contribute to the phenomenon of "heparin therapy resistance" (requirement of larger heparin doses than expected for achievement of therapeutic anticoagulation responses). However, it may more often have other pathophysiology, such as "acute-phase" elevation of coagulation factor VIII or plasma heparin-binding proteins.
Increased antithrombin activity is of unknown hemostatic
significance. Direct factor Xa inhibitors, rivaroxaban (Xarelto),
apixaban (Eliquis), and edoxaban (Savaysa) may falsely elevate the
antithrombin activity and mask a diagnosis of antithrombin
deficiency.
Limitations:
1. Patient should not be on the following medications as the
results may be falsely elevated:
* Direct thrombin inhibitor:
Pradaxa (dabigatran), Acova (argatroban)
* Direct Xa inhibitor: Xarelto
(rivaroxaban), Eliquis (apixaban), Savaysa (edoxaban)
* tPA (tissue plasma
activator)
Day(s) Test Set Up/TAT
Performed:
Daily
Available STAT
TAT:
STAT < 1 hr
Routine < 4 hrs
Aliases
None
CPT Code
85300