Thromb Haemost 2012; 108(04): 640-646
DOI: 10.1160/TH12-02-0124
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Biological variation in tPA-induced plasma clot lysis time

Simone Talens
1   Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
,
Joyce J. M. C. Malfliet
1   Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
,
Goran Rudež
1   Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
,
Henri M. H. Spronk
2   Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
,
Nicole A. H. Janssen
3   Center for Environmental Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
,
Piet Meijer
4   ECAT Foundation, Leiden, the Netherlands
,
Cornelis Kluft
4   ECAT Foundation, Leiden, the Netherlands
,
Moniek P. M. de Maat
1   Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
,
Dingeman C. Rijken
1   Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
› Author Affiliations
Further Information

Publication History

Received: 01 March 2012

Accepted after major revision: 03 July 2012

Publication Date:
29 November 2017 (online)

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Summary

Hypofibrinolysis is a risk factor for venous and arterial thrombosis, and can be assessed by using a turbidimetric tPA-induced clot lysis time (CLT) assay. Biological variation in clot lysis time may affect the interpretation and usefulness of CLT as a risk factor for thrombosis. Sufficient information about assay variation and biological variation in CLT is not yet available. Thus, this study aimed to determine the analytical, within-subject and between-subject variation in CLT. We collected blood samples from 40 healthy individuals throughout a period of one year (average 11.8 visits) and determined the CLT of each plasma sample in duplicate. The mean (± SD) CLT was 83.8 (± 11.1) minutes. The coefficients of variation for total variation, analytical variation, within-subject variation and between-subject variation were 13.4%, 2.6%, 8.2% and 10.2%, respectively. One measurement can estimate the CLT that does not deviate more than 20% from its true value. The contribution of analytical variation to the within-subject variation was 5.0%, the index of individuality was 0.84 and the reference change value was 23.8%. The CLT was longer in the morning compared to the afternoon and was slightly longer in older individuals (> 40 years) compared to younger (≤40 years) individuals. There was no seasonal variation in CLT and no association with air pollution. CLT correlated weakly with fibrinogen, C-reactive protein, prothrombin time and thrombin generation. This study provides insight into the biological variation of CLT, which can be used in future studies testing CLT as a potential risk factor for thrombosis.