Levels of acarboxy prothrombin (PIVKA-II) and coagulation factors in warfarin-treated patients.

PIVKA-II (protein induced by vitamin K absence or antagonists-II) was determined and compared with other coagulation factors in normal subjects and patients treated with the anticoagulant warfarin. In 18 (60%) of 30 patients treated with warfarin, PIVKA-II values were 1 microgram/ml or more, although they were less than 1 microgram/ml in all 39 normal subjects (100%). In patients treated with warfarin, values of prothrombin time and partial thromboplastin time were significantly higher than those in normal subjects. However, values of hepaplastintest (normotest) and thrombotest in the patients were greatly lower than those in normal subjects. There were no significant differences between bleeding time or plasma fibrinogen values in the patients and normal subjects. The values of PIVKA-II were inversely correlated (P less than 0.01) with those of hepaplastintest and thrombotest. The measurement of PIVKA-II in the plasma should be useful in detecting vitamin K-deficient status among haemorrhagic disorders.