Clinical Applications, Pitfalls, and Uncertainties of Thrombin Generation in the Presence of Platelets

Marina Panova-Noeva, Paola E. J. van der Meijden, Hugo ten Cate*

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

9 Citations (Web of Science)

Abstract

Platelet-dependent thrombin generation is a helpful tool to assess ex vivo the interaction between platelets and plasma coagulation factors in the initiation, amplification, and inhibition of thrombin generation (TG). This review article discusses the most relevant available data on the clinical applications of fluorogenic TG, the most widely used TG assay, performed in the presence of platelets, i.e., in platelet-rich plasma. With respect to prothrombotic states, arterial hypertension and obesity were the most prominent cardiovascular conditions linked to increased platelet-dependent TG. In addition, platelet-associated hypercoagulability, assessed by the TG assay, has been shown in individuals with active cancer. In terms of bleeding, platelet-dependent TG has been applied to assess bleeding risk in individuals with hemophilia, von Willebrand disease, and Glanzmann thrombasthenia as well as in subjects with other congenital or acquired coagulation factor deficiencies. In addition to risk prediction, a role of the TG assay has been suggested in monitoring antiplatelet therapy in prothrombotic conditions and replacement therapy in bleeding diathesis. Finally, for the routine clinical use and as a biomarker of disease development and progression, better standardization and clinical validation of platelet-dependent TG are still needed.

Original languageEnglish
Article number92
Number of pages10
JournalJournal of Clinical Medicine
Volume9
Issue number1
DOIs
Publication statusPublished - Jan 2020

Keywords

  • platelets
  • thrombin generation
  • cardiovascular risk factors
  • cardiovascular diseases
  • thrombosis
  • bleeding
  • hemophilia
  • von Willebrand disease
  • CALIBRATED AUTOMATED THROMBOGRAM
  • RECOMBINANT FACTOR VIIA
  • SEVERE HEMOPHILIA-A
  • FACTOR-V DEFICIENCY
  • RICH PLASMA
  • VENOUS THROMBOEMBOLISM
  • BLEEDING PHENOTYPE
  • ACTIVATION
  • HYPERCOAGULABILITY
  • OBESITY

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