Elsevier

Thrombosis Research

Volume 127, Supplement 3, February 2011, Pages S21-S25
Thrombosis Research

Thrombin generation tests

https://doi.org/10.1016/S0049-3848(11)70007-XGet rights and content

Abstract

The recent development of semi-automated methods has revived interest in the thrombin generation test, a global assay that measures the overall tendency of a plasma sample to form thrombin after initiation of coagulation. The thrombin generation curve, which is characterised by a lag phase followed by the formation and subsequent inhibition of thrombin, reflects all three phases of coagulation (initiation, propagation and termination). However, the specific contribution of each coagulation factor or inhibitor to the assay outcome depends on the reaction conditions used (e.g. tissue factor concentration used to trigger coagulation, addition of thrombomodulin or activated protein C). Although several studies have shown a correlation between thrombin generation and the risk of bleeding or venous thrombosis, the application of thrombin generation assays to clinical decision-making is still hampered by standardisation problems. The present paper discusses these issues with particular reference to Calibrated Automated Thrombography.

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      We thus measured thrombin generation parameters in our model of NS, their alteration with treatment with Pio and GQ-16, and correlation with proteinuria. A typical thrombin generation curve, as shown in Figure 5A, is characterized by a short lag phase, the area under the curve (endogenous thrombin potential), peak thrombin, and velocity index (Castoldi and Rosing, 2011). Representative curves from each of the study groups are shown in Figure 5B. Endogenous thrombin potential (ETP) is a consistently elevated thrombin generation parameter in NS (Kerlin et al., 2015; Waller et al., 2020), and we found it to be significantly increased in nephrotic rats (PAN, 3646 ± 199 nM∗min vs. Control, 2445 ± 402 nM∗min; p = 0.014) (Figures 5B and 5C).

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