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Test Code ATTF Antithrombin Activity, Plasma

Important Note

Name of test may include word "Functional"

  • Must be drawn at Outpatient Lab at the Main Campus 
  • Collect in Light Blue Tube

Reporting Name

Antithrombin Activity, P

Useful For

Diagnosis of antithrombin deficiency, acquired or congenital

 

Monitoring treatment of antithrombin deficiency disorders, including infusion of antithrombin therapeutic concentrate

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Plasma Na Cit


Ordering Guidance


Coagulation testing is highly complex, often requiring the performance of multiple assays and correlation with clinical information. For that reason, consider ordering AATHR / Thrombophilia Profile, Plasma and Whole Blood.



Specimen Required


Specimen Type: Platelet-poor plasma

Collection Container/Tube: Light-blue top (3.2% sodium citrate)

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions:

1. For complete instructions, see Coagulation Guidelines for Specimen Handling and Processing.

2. Centrifuge, transfer all plasma into a plastic vial, and centrifuge plasma again.

3. Aliquot plasma into a plastic vial leaving 0.25 mL in the bottom of centrifuged vial.

4. Freeze plasma immediately (no longer than 4 hours after collection) at -20° C or, ideally at -40° C or below.

Additional Information:

1. A double-centrifuged specimen is critical for accurate results as platelet contamination may cause spurious results.

2. Each coagulation assay requested should have its own vial.

3. Heparin treatment may lower plasma antithrombin.


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Plasma Na Cit Frozen 14 days

Day(s) Performed

Monday through Saturday

Test Classification

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

85300

LOINC Code Information

Test ID Test Order Name Order LOINC Value
ATTF Antithrombin Activity, P 27811-9

 

Result ID Test Result Name Result LOINC Value
ATTF Antithrombin Activity, P 27811-9

Interpretation

Antithrombin deficiencies due to inherited causes are much less common than those due to acquired causes (see Clinical Information). 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, see GNANT / Antithrombin Deficiency, SERPINC1 Gene, Next-Generation Sequencing, Varies.

 

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.(4)

 

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.

Clinical Reference

1. Lane DA, Olds RJ, Thein SL. Antithrombin and its deficiency. In: Bloom AL, Forbes CD, Thomas DP, eds. Haemostasis and Thrombosis. 3rd ed. Churchill Livingstone; 1994:655-670

2. Lane DA, Bayston T, Olds RJ, et al. Antithrombin mutation database: 2nd (1997) update. For the Plasma Coagulation Inhibitors Subcommittee of the Scientific and Standardization Committee of the International Society on Thrombosis and Haesmostasis. Thromb Haemost. 1997;77(1):197-211

3. Young G, Dricsoll MC. Coagulation abnormalities in the carbohydrate-deficient glycoprotein syndrome: case report and review of the literature. Am J Hematol. 1999;60(1):66-69. doi:10.1002/(sici)1096-8652(199901)60:1<66:aid-ajh11>3.0.co;2-d

4. Mammen EF. Antithrombin: its physiological importance and role in DIC. Semin Thromb Haemost. 1998;24(1):19-25. doi:10.1055/s-2007-995819

5. Yohe S, Olson J. Thrombophilia: Assays and Interpretation. In: Kottke-Marchant Wiley K, ed. Laboratory Hematology Practice. Blackwell Publishing; 2012:492-508

6. Favaloro EJ and Lippi G. eds. Hemostasis and Thrombosis: Methods and Protocols. 1st ed. Humana Press; 2017

Report Available

1 to 3 days

Method Name

Chromogenic Assay

Reference Values

Normal values: 80-130%

Normal, full-term newborn infants have lower levels (≥35-40%) that reach normal values by age 90 days. Premature infants (30-36 weeks gestation) have lower levels that reach normal values by age 180 days.