What is a coagulation profile?
A coagulation profile (coags) includes INR, APTT, platelets and fibrinogen. It is a screening test for abnormal blood clotting because it examines the factors most often associated with a bleeding problem. It does not cover all causes of bleeding tendencies.
Why would you need to get a coagulation profile?
A coagulation profile may be performed to confirm normal clotting function before a procedure which may cause bleeding, or in conditions associated with bleeding, for example from the respiratory, urinary, or gastrointestinal tract.
A coagulation profile may also be requested by your doctor if there is a concern about easy bruising or bleeding. This may happen because of hereditary conditions such as Haemophilia, or acquired conditions such as liver failure, or severe infections.
A condition called Disseminated Intravascular Coagulation (DIC) may occur in critically ill patients, from a variety of possible causes. DIC affects all the components of the coagulation profile.
Envenomation from some types of snakebite may also cause a coagulopathy – an abnormality of the normal clotting process. Warfarin therapy is a medical cause of easy bleeding and shows up in the INR component of the coagulation profile.
Coagulation profile includes
The Coagulation profile consists of a number of components, including:
- APTT (activated partial thromboplastin time)– measures one part of the clotting pathway known as the “intrinsic pathway”. it is compared against a sample of normal blood, the “control” value. It is increased by therapy with intravenous heparin, haemophilia or DIC.
- INR (international normalised ratio)– measures one part of the clotting pathway known as the “extrinsic pathway”. it is increased by warfarin therapy, liver dysfunction or DIC.
- Platelet Count– the number of platelets in the bloodstream; it is also a routine component of the Complete Blood Count (CBC)
- Fibrinogen– this protein is a precursor to fibrin, which is an essential part of a blood clot. Fibrinogen may be consumed by conditions such as DIC or some snakebite envenomations. Decreased fibrinogen results in an increased bleeding tendency.
- D-dimer is sometimes included – this is a product of clot breakdown and is increased in conditions of increased clotting activity in the body but is relatively non-specific because it is often elevated due to different reasons.
The specific results of the coagulation profile will help your doctor to decide whether any further investigations (tests) are required.
Purpose of a coagulation profile
Clotting disorders can cause a dangerous amount of bleeding or clotting. If your doctor suspects you have a clotting disorder, they may recommend one or more coagulation profile. These tests measure various proteins and how they function.
Conditions that can cause coagulation problems include:
- liver disease
- thrombophilia, which is excessive clotting
- haemophilia, which is an inability to clot normally
Coagulation profile is useful in monitoring people who take medications that affect clotting ability. Coagulation profile is also sometimes recommended before surgery.
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