Role of Noninvasive Urinary Prothrombin Fragment 1 + 2 to Measure Blood Coagulation Indices and Dose of Acenocoumarol

• Published in: Journal of proteome research Vol. 23; no. 12; pp. 5342 - 5351
• Main Authors: Gupta, Ashish, Kumar, Deepak, Bharti, Niharika, Kumar, Sudeep, Pande, Shantanu, Agarwal, Vikas
• Format: Journal Article
• Language: English
• Published: United States American Chemical Society 06.12.2024
• Subjects: Acenocoumarol - administration & dosage; Acenocoumarol - therapeutic use; Adult; Aged; anticoagulants; Anticoagulants - therapeutic use; Biomarkers - blood; Biomarkers - urine; blood; blood coagulation; Blood Coagulation - drug effects; Case-Control Studies; creatinine; drug therapy; Enzyme-Linked Immunosorbent Assay; Female; Humans; International Normalized Ratio; Male; Middle Aged; molecular weight; people; Peptide Fragments - blood; Peptide Fragments - urine; proteome; Prothrombin; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization - methods; t-test; urine; Western blotting; prothrombin fragment 1 + 2; cardiovascular diseases; acenocoumarol; international normalized ratio; coagulation
• ISSN: 1535-3893; 1535-3907; 1535-3907
• DOI: 10.1021/acs.jproteome.4c00462

PF1 + 2 plasma levels are a crucial indicator for assessing anticoagulant action in individuals receiving anticoagulant treatment. Urine also has PF1 + 2 levels due to its molecular size. Hence, the present study aims to measure urinary prothrombin fragment 1 + 2 (uPF1 + 2) in patients taking anticoagulants in order to divulge a noninvasive surrogate marker of PT-INR of blood coagulopathy. A total of 205 people participated in the study: 104 patients on acenocoumarol (AC) and 101 healthy controls (HC). Clinical parameters, including PT-INR, urinary creatinine, etc., were measured in all subjects. To evaluate uPF1 + 2 in samples, MALDI-TOF-MS, Western blot analysis, and ELISA tests were used. The MALDI-TOF-MS results showed the presence of uPF1 + 2 in both AC and HC urine samples. The Western blot, ELISA experiment, and unpaired t test results displayed that the patients with AC had significantly increased levels of uPF1 + 2 compared to HC. A regression study showed a strong positive relation between blood-based PT-INR and uPF1 + 2. ROC validation also revealed the clinical efficacy of uPF1 + 2. For the goal to monitor anticoagulant medication, the present study highlights PF1 + 2, which describes the overall hemostatic capacity and might be utilized in addition to or instead of PT-INR.