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Clotting is what prevents excessive bleeding when you cut yourself. But the blood moving through your vessels shouldn’t clot. If such clots form, they can travel through your bloodstream to your heart, lungs, or brain. This can cause a heart attack, stroke, or even death. Coagulation tests measure your blood’s ability to clot, and how long it takes to clot. Testing can help your doctor assess your risk of excessive bleeding or developing clots (thrombosis) somewhere in your blood vessels.


A bleeding disorder is an acquired or inherited tendency to bleed excessively. Normally, blood remains in the circulatory system inside the blood vessels. However, if veins or arteries are injured, they will begin to leak blood, either externally or into body tissues. The body stops the blood loss through a complex clotting process called haemostasis. During haemostasis, the injured blood vessel constricts to reduce blood flow, platelets adhere to the injury site and clump together to form a loose platelet plug, and a process of clot formation called the coagulation cascade is initiated.

Once the coagulation cascade has been initiated, coagulation factors are activated one after the other in a sequential process. As the cascade nears completion, soluble fibrinogen (fibrinogen dissolved in fluid) is changed into insoluble fibrin threads. These threads crosslink together to form a fibrin net that then stabilises at the injury site. The fibrin net adheres to the site of injury along with aggregated cell fragments called platelets to form a stable blood clot. This barrier prevents additional blood loss and remains in place until the injured area has healed. Haemostasis is a dynamic process, though, so once a clot is formed, other factors are activated to slow the clotting process. They eventually begin to dissolve the clot in a process called fibrinolysis so that the clot is removed when the injury site is healed. In normal, healthy individuals, this balance between clot formation and dissolution ensures that bleeding does not become excessive and that clots are removed once they are no longer needed.


No test preparation is needed. If the patient is receiving anticoagulant therapy, the specimen should be collected before the daily dose is taken. It is essential the blood is taken quickly and smoothly and that the anticoagulant bottle is filled exactly to the designated mark or the result may be inaccurate.


We use Roche CoaguChek Pro II system with an electrochemical determination of the PT and aPTT time after activation of coagulation cascade.


If you are taking an anticoagulant drug, your doctor will check your coagulation regularly to make sure that your prescription is working properly and that the INR is appropriately increased. There is no set frequency for doing the test. Your doctor will request it often enough to make sure that the drug dose is correct. Occasionally the coagulation check may be used on a patient who is not taking anticoagulant drugs—to check for a bleeding disorder, liver disease or vitamin K deficiency, or to ensure clotting ability before surgery.


Reference ranges: Prothrombin Time (PT): 11-13.5 seconds; International Normalised Ratio (INR) 0.8-1.1; The activated partial thromboplastin time (APTT): 30-40 seconds.

Interpretation of PT and aPTT in Patients with a Bleeding or Clotting Syndrome

The PT is often performed along with another clotting test called the aPTT (or sometimes the PTT or KCCT). Comparison of the two results can give your doctor information as to the cause of a bleeding problem.
PT result aPTT result Possible conditions present
Prolonged Normal Liver disease, decreased vitamin K, decreased or defective factor VII
Normal Prolonged Decreased or defective factor VIII, IX, XI or XII, von Willebrand disease, or lupus anticoagulant present
Prolonged Prolonged Decreased or defective factor I, II, V or X, liver disease, disseminated intravascular coagulation (DIC)
Normal Normal Decreased platelet function, thrombocytopenia, factor XIII deficiency, mild deficiencies in other factors, a mild form of von Willebrand’s disease, weak collagen


The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario. Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

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