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In general, hypercoagulability testing during acute thrombosis is not recommended as it does not change the mortality or management of patients. If testing was performed, important considerations are mentioned in the following image:
Protein S activity testing is the most unreliable test as it is affected by acute thrombosis, inflammation, anticoagulation with warfarin, liver disease, pregnancy, and estrogen use. Free protein S is the most ideal initial test to consider.
