What is the thrombin generation test?
What is the thrombin generation test?
Thrombin generation (TG) assays are used widely to investigate both diseases and drugs that impact thrombosis and bleeding. TG assays were also instrumental in the identification of thrombogenic impurities in immune globulin products, which were associated with thrombotic adverse events in patients.
What is thrombin generation?
The thrombin generation assay (TGA) measures the overall hemostatic potential of a plasma sample. Since the majority of thrombin is generated after initiation, TGA provides a broader picture of total clotting potential. As such, it can be predictive of a patient’s bleeding or thrombotic risk.
What is endogenous thrombin potential?
The endogenous thrombin potential (ETP), defined as the amount of thrombin which can be generated after the in vitro activation of coagulation with tissue factor as trigger and phospholipids as platelet substitute (Hemker et al, 1993) has been proposed as a laboratory tool to investigate hyper- or hypo-coagulability ( …
How is thrombin activity determined?
Thrombin is the key enzyme of coagulation. Its activity can be determined via fibrinogen Ø fibrin conversion or via cleavage of a chromogenic substrate. Higher substrate concentrations in a plasma milieu result in unspecific cleavage of the substrate.
How many reports are there on thrombin generation?
Currently, there are 7,446 reports under the term “ thrombin generation ” published in PubMed and most deal with the application of TG to investigate hypo- or hyper-coagulability.
What is the ETP of thrombin generation?
The time to reach the peak defines the velocity of TG and should be prolonged or shortened in conditions associated with hypo- or hypercoagulability, respectively. The area under the curve, known as the ETP, represents the net amount of thrombin that the test plasma can generate under the experimental conditions.
Are there any tests for thrombin generation in vivo?
Historically, thrombin generation has been investigated by means of the basic tests of coagulation, prothrombin time (PT) and activated partial thromboplastin time (APTT). However, recent observations indicate that these tests are not suited to represent the balance of coagulation that occurs in vivo ( 7 ).
Is the TG procedure used to monitor thrombin generation?
In principle, every treatment aimed at preventing/treating hemorrhage accomplishes its goal by increasing thrombin generation. In this respect, the TG procedure is the most promising laboratory tool to monitor patients on treatment.
