ABSTRACT
Thrombin plays an important role in hemostasis through its multiple functions across
blood coagulation, platelet activation, and fibrinolysis. The measurement of thrombin
generation is therefore viewed as a potentially useful test that could be applied
to the screening, monitoring, and/or diagnosis of hemostatic abnormalities. Indeed,
advances in thrombin generation assays have created significant interest and debate
as to whether they may provide a more physiologically relevant testing system than
do traditional coagulation tests. A variety of thrombin generation assays, including
commercially available systems, have been investigated for their correlation with
hypocoagulable and hypercoagulable states. Although there is an extensive body of
literature that has investigated the application of thrombin generation assays, some
limitations remain. These include poor standardization of reagents and methods and
a lack of large prospective studies that demonstrate clear relationships between thrombin
generation with bleeding and thrombosis phenotypes, as well as with monitoring anticoagulation.
Whether thrombin generation assays become more “useful” than “hype” will require well-designed,
large, prospective multicenter trials using standardized methods.
KEYWORDS
Thrombin generation assays - hemostasis - laboratory testing - thrombosis - bleeding
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Murray AdamsPh.D. M.A.I.M.S.
School of Human Life Sciences, University of Tasmania
Tasmania 7250, Australia
eMail: Murray.Adams@utas.edu.au
