Hyper-coagulability in obese patients accurately identified by combinations of global coagulation assay parameters.

Bertaggia Calderara, Debora; Aliotta, Alessandro; Zermatten, Maxime G; Kröll, Dino; Stirnimann, Guido; Alberio, Lorenzo (2020). Hyper-coagulability in obese patients accurately identified by combinations of global coagulation assay parameters. Thrombosis research, 187, pp. 91-102. Elsevier 10.1016/j.thromres.2020.01.012

[img] Text
1-s2.0-S0049384820300128-main.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (2MB) | Request a copy

BACKGROUND

Routine laboratory methods are insensitive to hyper-coagulation, which may be detected by global hemostasis tests. Calibrated Automated Thrombogram (CAT) is a gold standard method to measure thrombin generation and coagulation potential. Thrombodynamics (TD) is a new global assay that monitors the spatio-temporal propagation of blood coagulation, separating initiation from amplification/propagation phases of coagulation and visualizing fibrin clot formation.

AIM

We investigated whether CAT and/or TD can identify hyper- and hypo-coagulable states in patients with well-characterized phenotypes and which parameters could be used as potential predictors of thrombotic risk.

METHODS

Blood was collected from: (1) forty healthy volunteers; (2) twelve obese patients scheduled for bariatric surgery (BMI ≥ 35 kg/m2); (3) nine patients under therapy with vitamin K-antagonists (median INR 2.7); (4) eight patients treated with low molecular weight heparins (anti-Xa activity between 0.5 and 0.7 U anti-Xa/ml); (5) ten patients with hemophilia A or B. Tissue factor induced thrombin generation was measured with CAT. Propagation of thrombin generation and clot growth from a tissue factor coated surface were monitored with TD.

RESULTS

Thrombin generation and fibrin clot formation parameters were significantly higher in obese patients compared to healthy volunteers and anticoagulated or hemophilic patients. ROC analysis of combined CAT or CAT/TD parameters (integrating thrombin generation and fibrin clot formation) demonstrated an excellent accuracy in detecting hyper-coagulability.

CONCLUSION

Combinations of CAT assay parameters and of parameters of thrombin generation burst with final fibrin clot properties allow recognizing accurately hyper-coagulable plasma and may represent predictive markers for thrombotic events.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery

UniBE Contributor:

Kröll, Dino and Stirnimann, Guido

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0049-3848

Publisher:

Elsevier

Language:

English

Submitter:

Rahel Fuhrer

Date Deposited:

18 Dec 2020 08:35

Last Modified:

18 Dec 2020 08:35

Publisher DOI:

10.1016/j.thromres.2020.01.012

PubMed ID:

31978812

Uncontrolled Keywords:

Global hemostasis test Hyper-coagulation Thrombin generation Thrombodynamics Thrombotic risk

BORIS DOI:

10.7892/boris.148421

URI:

https://boris.unibe.ch/id/eprint/148421

Actions (login required)

Edit item Edit item
Provide Feedback