Cold activation in PT-INR samples–Myth or reality in the modern laboratory?
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| Title: | Cold activation in PT-INR samples–Myth or reality in the modern laboratory? |
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| Authors: | Petersson, Annika, Strandberg, Karin, Magnusson, Magnus, Lerman, Jenny, Ekblom, Kim |
| Contributors: | Lund University, Faculty of Medicine, Department of Translational Medicine, Clinical Chemistry, Malmö, Lunds universitet, Medicinska fakulteten, Institutionen för translationell medicin, Klinisk kemi, Malmö, Originator |
| Source: | Scandinavian Journal of Clinical and Laboratory Investigation. 85(3):175-179 |
| Subject Terms: | Medical and Health Sciences, Health Sciences, Occupational Health and Environmental Health, Medicin och hälsovetenskap, Hälsovetenskap, Arbetsmedicin och miljömedicin |
| Description: | Guidelines on storage for samples intended for Prothrombin Time–International Normalized Ratio (PT-INR) analysis have changed over time, sometimes advising against cold storage due to presumed cold activation of the coagulation cascade. Previous studies on PT-INR storage have mainly been underpowered, performed in glass tubes, and not in a modern laboratory setting. In this study, we re-analyzed 1149 PT-INR samples, divided into low-level samples (PT-INR <1.3), and high-level samples (PT-INR 1.8–3.5) after 3 h of cold storage. We found no statistical difference for high-level samples but statistically higher PT-INR values in low-level samples. The differences were minor and not considered clinically relevant. No cold activation could be detected, as cold activation would have diminished PT-INR. These findings open the possibility of transporting and storing centrifuged PT-INR samples refrigerated. The higher PT-INR values in low-level samples after cold storage impede a mechanistic principle that needs to be further investigated. |
| Access URL: | https://doi.org/10.1080/00365513.2025.2487972 |
| Database: | SwePub |
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Nájsť tento článok vo Web of Science | Abstract: | Guidelines on storage for samples intended for Prothrombin Time–International Normalized Ratio (PT-INR) analysis have changed over time, sometimes advising against cold storage due to presumed cold activation of the coagulation cascade. Previous studies on PT-INR storage have mainly been underpowered, performed in glass tubes, and not in a modern laboratory setting. In this study, we re-analyzed 1149 PT-INR samples, divided into low-level samples (PT-INR <1.3), and high-level samples (PT-INR 1.8–3.5) after 3 h of cold storage. We found no statistical difference for high-level samples but statistically higher PT-INR values in low-level samples. The differences were minor and not considered clinically relevant. No cold activation could be detected, as cold activation would have diminished PT-INR. These findings open the possibility of transporting and storing centrifuged PT-INR samples refrigerated. The higher PT-INR values in low-level samples after cold storage impede a mechanistic principle that needs to be further investigated. |
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| ISSN: | 00365513 15027686 |
| DOI: | 10.1080/00365513.2025.2487972 |