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26231 Activated Protein C Resistance V, Plasma (APCRV)

Activated Protein C Resistance V, Plasma (APCRV)
Test Code: APCRVSO
Synonyms/Keywords

​Activated Protein CV deficient

APCRV (Activated Protein C Resistance V)

Useful For

Evaluation of patients with incident or recurrent venous thromboembolism (VTE)

Evaluation of individuals with a family history of VTE

Specimen Requirements
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Platelet-Poor Plasma​Citrated Light Blue Top Tube (BTT)​1 mL​0.5 mL
Collection Processing Instructions

Collection Instructions:

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

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

3. Freeze plasma immediately (no longer than 4 hours after collection) at -20 degrees C, or, ideally < or =-40 degrees C

Additional Information:

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

2. If priority specimen, mark request form, give reason, and request a call-back.

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

Specimen Stability Information
Specimen TypeTemperatureTime
​Plasma Na Cit​Frozen​14 days
Rejection Criteria
Gross Hemolysis
​Gross Lipemia
​Gross Icterus
Interference

This assay is highly sensitive and specific for inherited activated protein C (APC) resistance, most commonly due to the factor V Leiden mutation, but it will not detect patients with acquired APC resistance. Persons with acquired APC resistance are at similar risk for venous thromboembolism.

Preanalytical conditions of the patient and the blood specimen are extremely important for reliable performance and interpretation of testing for APC resistance. Plasmas demonstrating prolongation of clotting times (prothrombin time, activated partial thromboplastin time) for reasons other than anticoagulant effects (eg, lupuslike anticoagulants or specific coagulation factor inhibitors) generally cannot be reliably tested for the presence or absence of APC resistance. Proper preparation of the blood (plasma) specimen is extremely important to help insure accuracy of results and interpretation.

The activated protein C resistance ratio (APCRV) assay has greater than 99% sensitivity for detecting the presence of a factor V Leiden mutation. Discrepant results of plasma-based APCRV and DNA-based factor V Leiden testing may occur in recipients of liver or allogeneic hematopoietic stem cell transplants; or due to anticoagulant effects such as excess heparin; direct thrombin inhibitors argatroban (Acova), bivalirudin (Angiomax), or dabigatran (Pradaxa); or direct factor Xa inhibitors rivaroxaban (Xarelto), apixaban (Eliquis), and edoxaban (Savaysa); or a sample mix-up. Clinical correlation is suggested. If clinically indicated, consider follow-up repeat APCR testing or direct DNA-based testing for the factor V Leiden (R506Q) mutation (F5DNA / Factor V Leiden [R506Q] Mutation, Blood). 

Performing Laboratory Information
Performing LocationDay(s) Test PerformedReport AvailableMethodology/Instrumentation
​Mayo Clinic Laboratories​Monday through Friday​1 to 3 days​Optical Clot-Based
Reference Lab
Reference Range Information
Performing LocationReference Range
​Mayo Clinic Laboratories

APCRV RATIO

> or =2.3

Pediatric reference range has neither been established nor is available in scientific literature. The adult reference range likely would be applicable to children older than 6 months.​

Interpretation

​An activated protein C (APC) resistance ratio of less than 2.3 suggests abnormal resistance to APC of hereditary origin.

If the APC resistance test is abnormal, DNA-based testing for the factor V Leiden mutation (F5DNA / Factor V Leiden [R506Q] Mutation, Blood) may be helpful in confirming or excluding hereditary APC resistance.

Outreach CPTs
CPTModifier
(if needed)
QuantityDescriptionComments
​85307​1
Synonyms/Keywords

​Activated Protein CV deficient

APCRV (Activated Protein C Resistance V)

Ordering Applications
Ordering ApplicationDescription
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Platelet-Poor Plasma​Citrated Light Blue Top Tube (BTT)​1 mL​0.5 mL
Collection Processing

Collection Instructions:

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

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

3. Freeze plasma immediately (no longer than 4 hours after collection) at -20 degrees C, or, ideally < or =-40 degrees C

Additional Information:

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

2. If priority specimen, mark request form, give reason, and request a call-back.

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

Specimen Stability Information
Specimen TypeTemperatureTime
​Plasma Na Cit​Frozen​14 days
Rejection Criteria
Gross Hemolysis
​Gross Lipemia
​Gross Icterus
Interference

This assay is highly sensitive and specific for inherited activated protein C (APC) resistance, most commonly due to the factor V Leiden mutation, but it will not detect patients with acquired APC resistance. Persons with acquired APC resistance are at similar risk for venous thromboembolism.

Preanalytical conditions of the patient and the blood specimen are extremely important for reliable performance and interpretation of testing for APC resistance. Plasmas demonstrating prolongation of clotting times (prothrombin time, activated partial thromboplastin time) for reasons other than anticoagulant effects (eg, lupuslike anticoagulants or specific coagulation factor inhibitors) generally cannot be reliably tested for the presence or absence of APC resistance. Proper preparation of the blood (plasma) specimen is extremely important to help insure accuracy of results and interpretation.

The activated protein C resistance ratio (APCRV) assay has greater than 99% sensitivity for detecting the presence of a factor V Leiden mutation. Discrepant results of plasma-based APCRV and DNA-based factor V Leiden testing may occur in recipients of liver or allogeneic hematopoietic stem cell transplants; or due to anticoagulant effects such as excess heparin; direct thrombin inhibitors argatroban (Acova), bivalirudin (Angiomax), or dabigatran (Pradaxa); or direct factor Xa inhibitors rivaroxaban (Xarelto), apixaban (Eliquis), and edoxaban (Savaysa); or a sample mix-up. Clinical correlation is suggested. If clinically indicated, consider follow-up repeat APCR testing or direct DNA-based testing for the factor V Leiden (R506Q) mutation (F5DNA / Factor V Leiden [R506Q] Mutation, Blood). 

Useful For

Evaluation of patients with incident or recurrent venous thromboembolism (VTE)

Evaluation of individuals with a family history of VTE

Reference Range Information
Performing LocationReference Range
​Mayo Clinic Laboratories

APCRV RATIO

> or =2.3

Pediatric reference range has neither been established nor is available in scientific literature. The adult reference range likely would be applicable to children older than 6 months.​

Interpretation

​An activated protein C (APC) resistance ratio of less than 2.3 suggests abnormal resistance to APC of hereditary origin.

If the APC resistance test is abnormal, DNA-based testing for the factor V Leiden mutation (F5DNA / Factor V Leiden [R506Q] Mutation, Blood) may be helpful in confirming or excluding hereditary APC resistance.

For more information visit:
Performing Laboratory Information
Performing LocationDay(s) Test PerformedReport AvailableMethodology/Instrumentation
​Mayo Clinic Laboratories​Monday through Friday​1 to 3 days​Optical Clot-Based
Reference Lab
For billing questions, see Contacts
Outreach CPTs
CPTModifier
(if needed)
QuantityDescriptionComments
​85307​1
For most current information refer to the Marshfield Laboratory online reference manual.