Biological variation in tPA-induced plasma clot lysis time

Simone Talens; Joyce J. M. C. Malfliet; Goran Rudež; Henri M. H. Spronk; Nicole A. H. Janssen; Piet Meijer; Cornelis Kluft; Moniek P. M. de Maat; Dingeman C. Rijken

doi:10.1160/TH12-02-0124

Thrombosis and Haemostasis, Table of Contents

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

Authors

Simone Talens

¹Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
Joyce J. M. C. Malfliet

¹Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
Goran Rudež

¹Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
Henri M. H. Spronk

²Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
Nicole A. H. Janssen

³Center for Environmental Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
Piet Meijer

⁴ECAT Foundation, Leiden, the Netherlands
Cornelis Kluft

⁴ECAT Foundation, Leiden, the Netherlands
Moniek P. M. de Maat

¹Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
Dingeman C. Rijken

¹Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands

Abstract

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.

Keywords

CLT - biological variation - fibrinolysis

Full Text

References

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