Activated Protein C-Resistance (APCR) Test: Booking, Price, and Results
About Activated Protein C-Resistance (APCR) Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | APCR, APC Resistance Test, Factor V Leiden Screening Test, APC Ratio Test |
| Sample Type | Plasma (citrated blood) |
| Fasting Required | 8 hours preferred but not required |
| Report Time | 24 Days |
| Recommended For | Adults with unexplained blood clots, family history of venous thromboembolism, or recurrent miscarriages |
| Price | Starting at ₹5,000 |
What is an Activated Protein C-Resistance (APCR) Test?
The Activated Protein C-Resistance (APCR) Test measures how well your blood responds to a natural anticoagulant protein called activated protein C (APC). APC normally helps prevent excessive clotting by breaking down certain clotting factors. When the blood does not respond properly to APC, there is a higher risk of forming abnormal blood clots.
This test is also called the APC Resistance Test or Factor V Leiden Screening Test. It is typically ordered when a doctor suspects an inherited or acquired clotting disorder. A blood sample collected in a special citrate tube is used for testing.
What Does an Activated Protein C-Resistance (APCR) Test Measure?
The APCR test evaluates how effectively activated protein C regulates the clotting process. It looks at the following:
| Component | What it Assesses |
|---|---|
| APCR Ratio | The overall anticoagulant response of plasma to activated protein C |
| Factor V Sensitivity | Whether clotting Factor V is properly broken down by APC |
| Factor VIII Sensitivity | Whether clotting Factor VIII responds correctly to APC-mediated regulation |
When any of these components resist APC's action, thrombin (the main clotting enzyme) production increases, raising the risk of blood clots.
Why is an Activated Protein C-Resistance (APCR) Test Done?
Doctors order this test to investigate abnormal clotting in patients and to screen individuals who may carry a genetic clotting risk.
Common Symptoms That May Require This Test
The following symptoms may prompt a doctor to prescribe the APCR test:
- Swelling or pain in the leg, which may suggest a deep vein clot
- Sudden shortness of breath without a clear cause
- Unexplained chest pain
- Blood clots occurring before the age of 50
- Blood clots at unusual locations in the body
- Recurrent pregnancy loss
- A confirmed blood clot in a close family member
Conditions This Test Can Help Detect
This test can help identify several clotting-related conditions, including:
- Factor V Leiden thrombophilia, a genetic disorder that increases the risk of clotting
- Deep vein thrombosis (DVT), particularly in the legs
- Pulmonary embolism (a blood clot in the lungs)
- Superficial thrombophlebitis (inflammation of veins near the skin surface)
- Blood clots in unusual veins, such as those in the abdomen or brain
- Stroke in younger adults
- Recurrent miscarriage linked to clotting disorders
How to Prepare and What to Expect
Preparation for the APCR test is straightforward, but a few steps will help ensure accurate results.
Do You Need to Fast?
Fasting for 8 hours is preferred but not strictly required. You may drink water normally. If your doctor has ordered additional tests alongside this one, those may require stricter fasting. Always follow your doctor's specific instructions.
Practical Tips Before Your Test
Keep the following in mind before you go for sample collection:
- Inform your doctor about all medications you are currently taking, especially blood thinners such as warfarin, heparin, or direct oral anticoagulants
- Let your doctor know if you use hormonal contraceptives or hormone replacement therapy, as these can affect results
- If you are on anticoagulant therapy, your doctor may advise stopping it at least one week before the test where clinically safe to do so
- Drink adequate water beforehand to make the blood draw easier
- Wear a loose, short-sleeved top for easy access to the arm
Step-by-Step Procedure
Here is what to expect during the APCR test procedure:
- A trained phlebotomist will clean the skin on your inner elbow with an antiseptic solution.
- A needle is used to draw approximately 3 ml of blood into a light-blue top tube containing 3.2% sodium citrate, a special solution used for clotting tests.
- The tube is gently mixed by inversion to prevent clotting within the collection tube itself.
- The sample must reach the laboratory within 4 hours of collection to maintain accuracy.
- At the laboratory, the sample is centrifuged (spun) at high speed twice to separate the plasma and remove platelets.
- The plasma is then frozen and processed using a clot-based assay to calculate the APCR ratio.
Factors That Can Affect Accuracy
Certain factors may influence the reliability of your result:
- Use of anticoagulant medications such as warfarin, heparin, rivaroxaban, apixaban, dabigatran, or argatroban
- Presence of lupus anticoagulants in the blood
- Low protein S levels or acute phase reactions (inflammation)
- Use of oral contraceptives or hormone therapy
- Pregnancy or the period immediately after delivery
- Liver dysfunction or vitamin K deficiency
Understanding Your Activated Protein C-Resistance (APCR) Test Results
Your result is expressed as a ratio. A higher ratio generally indicates a normal response to activated protein C, while a lower ratio may suggest resistance. The table below shows general reference ranges.
| Parameter | Range | Interpretation |
|---|---|---|
| APCR Ratio (Normal) | 2.0 to 2.3 or above | Normal APC response |
| Heterozygous Factor V Leiden (one copy of the mutation) | 1.5 to 1.8 | Reduced APC response |
| Homozygous Factor V Leiden (two copies of the mutation) | 1.1 to 1.4 | Significantly reduced APC response |
These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Certain medical situations can cause misleading results:
A falsely low ratio may be seen in people with reduced protein S levels, liver disease, or those experiencing an acute inflammatory reaction.
Conversely, a falsely high ratio can occur in people taking anticoagulants, those with certain factor deficiencies, or in those with lupus anticoagulants present.
Hormone therapy and oral contraceptives may also alter the ratio.
People who have received a liver transplant or haematopoietic stem cell transplant may show results that do not match DNA-based genetic testing.
How to Maintain Healthy Levels
These general wellness tips may help reduce blood clot risk:
- Keep a healthy body weight and stay physically active, as prolonged inactivity increases the risk of clotting
- Stay well hydrated, particularly during long journeys by air or road
- If you have a family history of clotting disorders, discuss preventive options with your doctor before surgery, travel, or pregnancy
Lupin Diagnostics Activated Protein C-Resistance (APCR) Test Price and Home Collection
The APCR test is available at Lupin Diagnostics starting at ₹5,000, with home sample collection available in select cities across India.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 5000 |
| CHENNAI | 5000 |
| HYDERABAD | 5000 |
| KOLKATA | 5000 |
| NAVI MUMBAI | 5000 |
| PUNE | 5000 |
Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Follow these steps to book your APCR test online:
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred time slot.
- Opt for home sample collection by a certified phlebotomist, or visit your nearest Lupin Diagnostics centre.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Home Collection
Lupin Diagnostics offers home collection for the APCR test across multiple cities in India. Your sample is collected by a trained phlebotomist and processed in NABL-accredited laboratories. Digital reports are accessible via email or WhatsApp once ready.
Frequently Asked Questions
The Activated Protein C-Resistance (APCR) Test is used to evaluate patients who have had one or more episodes of abnormal blood clotting. It is also ordered for people with a strong family history of venous thromboembolism to check whether a hereditary clotting defect may be present.
APCR can be inherited or acquired. The most common inherited cause is a mutation in the Factor V gene, known as Factor V Leiden. Acquired causes include pregnancy, oestrogen use through contraceptives or hormone therapy, and certain conditions affecting the immune system.
Fasting for 8 hours is preferred but not compulsory. You may have water as normal. Always inform your doctor about any medications or supplements you are taking before the test.
Yes, several medications can interfere with the result. Direct oral anticoagulants such as rivaroxaban, apixaban, and dabigatran, as well as heparin and warfarin, can cause misleading readings. Your doctor may advise pausing these medications before testing, where it is medically safe to do so.
An abnormal ratio suggests resistance to APC, which may be hereditary. Your doctor will typically recommend a DNA-based test to confirm or rule out the Factor V Leiden mutation. This follow-up test provides a definitive genetic answer.
Pregnancy itself can lower the APCR ratio and affect results. Your doctor may recommend waiting until after delivery for accurate testing, though the test may still be performed in specific clinical situations where the benefit outweighs the uncertainty in results.
APCR is the most common inherited defect of the clotting system identified so far. It is found in approximately 3 to 5% of the general population and in around 21% of people diagnosed with deep vein thrombosis, making it a significant factor in clotting disorder investigations.
Activated Protein C-Resistance (APCR) Test: Booking, Price, and Results
