Use of calibrated automated thrombinography ± thrombomodulin to recognise the prothrombotic phenotype

Yesim Dargaud; M. Christine Trzeciak; Jean Claude Bordet; Jacques Ninet; Claude Negrier

doi:10.1160/TH06-03-0179

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2006; 96(05): 562-567
DOI: 10.1160/TH06-03-0179

Theme Issue Article

Schattauer GmbH

Use of calibrated automated thrombinography ± thrombomodulin to recognise the prothrombotic phenotype

Yesim Dargaud

¹Unite d’Hemostase Clinique – Laboratoire d’Hemostase, Hopital Edouard Herriot, Lyon, France

²Service d’Angiologie – Explorations Vasculaires, Hopital Edouard Herriot, Lyon, France

,

M. Christine Trzeciak

¹Unite d’Hemostase Clinique – Laboratoire d’Hemostase, Hopital Edouard Herriot, Lyon, France

,

Jean Claude Bordet

¹Unite d’Hemostase Clinique – Laboratoire d’Hemostase, Hopital Edouard Herriot, Lyon, France

,

Jacques Ninet

²Service d’Angiologie – Explorations Vasculaires, Hopital Edouard Herriot, Lyon, France

³Service de Médecine Interne, Hopital Edouard Herriot, Lyon, France

,

Claude Negrier

¹Unite d’Hemostase Clinique – Laboratoire d’Hemostase, Hopital Edouard Herriot, Lyon, France

› Author Affiliations

Abstract

Summary

There is currently no validated method to detect a prothrombotic phenotype. The question remains, can tissue factor (TF) induced thrombin generation (TG), as measured with the calibrated automated thrombinography (CAT) technique, according to Hemker et al., recognise a prothrombotic state either as such, or when the activated proteinC (APC)-system is boosted with thrombomodulin (TM)? We determined the normal range of CAT-TG ± TM in a group of 71 healthy blood donors, in 11 healthy women using oral contraceptives (OC), and in 89 patients with a history of venous thromboembolism (VTE), divided into a group of 50 in whicha prothrombotic risk factor could be found (VTEprf+) and 39 others (VTEprf-). The endogenous thrombin potential (ETP) in the OC, VTEprf+ and VTEprf-group was significantly higher than for the controls. In the presence of TM, the differences were significantly higher than in its absence. The VTEprf+ group had a higher ETP, ± TM than the VTEprf group. In conclusion,TG, measured with the CAT technique in the presence of TM is capable of detecting the prothrombotic phenotype with a high sensitivity of 0.93 (95% confidence limits 0.82–0.99).

Keywords

Thrombin generation - thrombomodulin - hypercoagulability - calibrated automated thrombogram,venous thromboembolism

Full Text

References

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