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The partial thromboplastin time (PTT), also known as the activated partial thromboplastin time (aPTT or APTT), is a blood test that characterizes coagulation of the blood.A historical name for this measure is the Kaolin-cephalin clotting time (KCCT), [1] reflecting kaolin and cephalin as materials historically used in the test.
Clotting time is a general term for the time required for a sample of blood to form a clot, or, in medical terms, coagulate.The term "clotting time" is often used when referring to tests such as the prothrombin time (PT), activated partial thromboplastin time (aPTT or PTT), activated clotting time (ACT), thrombin time (TT), or Reptilase time.
These tests include prothrombin time (PT/INR), activated partial thromboplastin time (aPTT), albumin, bilirubin (direct and indirect), and others. The liver transaminases aspartate transaminase (AST or SGOT) and alanine transaminase (ALT or SGPT) are useful biomarkers of liver injury in a patient with some degree of intact liver function.
Fresh normal plasma has all the blood coagulation factors with normal levels. If the problem is a simple factor deficiency, mixing the patient plasma 1:1 with plasma that contains 100% of the normal factor level results in a level ≥50% in the mixture (say the patient has an activity of 0%; the average of 100% + 0% = 50%). [3]
The ISI is usually between 0.94 and 1.4 for more sensitive and 2.0–3.0 for less sensitive thromboplastins. [ 5 ] [ 6 ] [ 7 ] The INR is the ratio of a patient's prothrombin time to a normal (control) sample, raised to the power of the ISI value for the analytical system being used.
This test is repeated with pooled plasma from normal patients. The difference in time between the test and the 'normal' indicates an abnormality in the conversion of fibrinogen (a soluble protein) to fibrin, an insoluble protein. [2] The thrombin time compares the rate of clot formation to that of a sample of normal pooled plasma.
The aPTT-based APC resistance test involves a modified aPTT test performed in the presence and absence of activated protein C (APC). [1] [5] The ratio of these aPTT values is calculated and is called the APC sensitivity ratio (APCsr) or simply APC ratio (APCr). [1] [5] This ratio is inversely related to the degree of APC resistance. [7]
Lupus-sensitive aPTT, of which many variants exist, but have the common feature of having a greater sensitivity of becoming prolonged in the presence of lupus anticoagulant compared to a regular aPTT.