Hyper-coagulability in obese patients accurately identified by combinations of global coagulation assay parameters.

Détails

ID Serval
serval:BIB_9986843240DA
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Hyper-coagulability in obese patients accurately identified by combinations of global coagulation assay parameters.
Périodique
Thrombosis research
Auteur⸱e⸱s
Bertaggia Calderara D., Aliotta A., Zermatten M.G., Kröll D., Stirnimann G., Alberio L.
ISSN
1879-2472 (Electronic)
ISSN-L
0049-3848
Statut éditorial
Publié
Date de publication
15/01/2020
Peer-reviewed
Oui
Volume
187
Pages
91-102
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Résumé
Routine laboratory methods are insensitive to hyper-coagulation, which may be detected by global hemostasis tests. Calibrated Automated Thrombogram (CAT) is a gold standard method to measure thrombin generation and coagulation potential. Thrombodynamics (TD) is a new global assay that monitors the spatio-temporal propagation of blood coagulation, separating initiation from amplification/propagation phases of coagulation and visualizing fibrin clot formation.
We investigated whether CAT and/or TD can identify hyper- and hypo-coagulable states in patients with well-characterized phenotypes and which parameters could be used as potential predictors of thrombotic risk.
Blood was collected from: (1) forty healthy volunteers; (2) twelve obese patients scheduled for bariatric surgery (BMI ≥ 35 kg/m <sup>2</sup> ); (3) nine patients under therapy with vitamin K-antagonists (median INR 2.7); (4) eight patients treated with low molecular weight heparins (anti-Xa activity between 0.5 and 0.7 U anti-Xa/ml); (5) ten patients with hemophilia A or B. Tissue factor induced thrombin generation was measured with CAT. Propagation of thrombin generation and clot growth from a tissue factor coated surface were monitored with TD.
Thrombin generation and fibrin clot formation parameters were significantly higher in obese patients compared to healthy volunteers and anticoagulated or hemophilic patients. ROC analysis of combined CAT or CAT/TD parameters (integrating thrombin generation and fibrin clot formation) demonstrated an excellent accuracy in detecting hyper-coagulability.
Combinations of CAT assay parameters and of parameters of thrombin generation burst with final fibrin clot properties allow recognizing accurately hyper-coagulable plasma and may represent predictive markers for thrombotic events.
Mots-clé
Global hemostasis test, Hyper-coagulation, Thrombin generation, Thrombodynamics, Thrombotic risk
Pubmed
Création de la notice
29/01/2020 15:55
Dernière modification de la notice
19/11/2020 7:26
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