Biomarkers for the diagnosis of venous thromboembolism: D-dimer, thrombin generation, procoagulant phospholipid and soluble P-selectin

Riva, Nicoletta; Vella, Kevin; Hickey, Kieron; Bertù, Lorenza; Zammit, Daniel; Spiteri, Silvana; Kitchen, Steve; Makris, Michael; Ageno, Walter; Gatt, Alex

doi:10.1136/jclinpath-2018-205293

Cited by 22 publications

(40 citation statements)

References 24 publications

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“…TGA have showed prolonged time to peak (T max ) and time to initiation of coagulation (T lag ) in acute VTE, possibly related to consumption of coagulation factors in the formation of the thrombus. [8][9][10][11][12] In contrast, other studies have found an increased total thrombin generating capacity measured as the area under the curve (AUC), 8,9 which would not be the case after consumption of coagulation factors. Similarly, an increased thrombin generating capacity has been demonstrated in intermediate and serious thrombophilic phenotypes 13 and has been associated with an increased risk of first VTE and unprovoked recurrent VTE, 14,15 although there are conflicting results.…”

Section: Introductionmentioning

confidence: 90%

Diagnostic Accuracy in Acute Venous Thromboembolism: Comparing D-Dimer, Thrombin Generation, Overall Hemostatic Potential, and Fibrin Monomers

Farm

Antovič

Schmidt

et al. 2020

TH Open

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Introduction For acute venous thromboembolism (VTE), a biomarker with higher specificity than D-dimer would be of great clinical use. Thrombin generation and overall hemostatic potential (OHP) reflect the hemostatic balance by globally assessing multiple coagulation factors and inhibitors. These tests discriminate between healthy controls and patients with a prothrombotic tendency but have yet to be established as clinical biomarkers of VTE. Objective This study compares endogenous thrombin potential (ETP) and OHP to D-dimer and fibrin monomers (FM) in outpatients with suspected VTE. Methods A cross-sectional diagnostic study where 954 patients with suspected pulmonary embolism or deep venous thrombosis were recruited consecutively from the medical emergency department at Karolinska University Hospital. D-dimer, FM, OHP, and ETP were analyzed in a subpopulation of 60 patients with VTE and 98 matched controls without VTE. VTE was verified either by ultrasonography or computed tomography and clinical data were collected from medical records. Results Compared with healthy controls, both VTE and non-VTE patients displayed prothrombotic profiles in OHP and ETP. D-dimer, FM, ETP area under the curve (AUC), and ETP Tlag were significantly different between patients with VTE and non-VTE. The largest receiver-operating characteristic AUCs for discrimination between VTE and non-VTE, were found in D-dimer with 0.94, FM 0.77, and ETP AUC 0.65. No useful cutoff could be identified for the ETP or the OHP assay. Conclusion Compared with D-dimer, neither ETP nor OHP were clinically viable biomarkers of acute venous thrombosis. The data indicated that a large portion of the emergency patients with suspected VTE were in a prothrombotic state.

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Section: Introductionmentioning

confidence: 90%

Diagnostic Accuracy in Acute Venous Thromboembolism: Comparing D-Dimer, Thrombin Generation, Overall Hemostatic Potential, and Fibrin Monomers

Farm

Antovič

Schmidt

et al. 2020

TH Open

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show abstract

Section: Introductionmentioning

confidence: 99%

“…When platelet activation occurs, a greater amount of thrombin is generated during the amplification and propagation of the coagulation cascade, resulting in an exponential increase of thrombin. [13][14][15][16][17] Thrombin is considered the key enzyme of the coagulation system. The thrombin generation test (TGT) has emerged as a tool capable of assessing global hemostasis in a more physiological manner than conventional tests.…”

Section: Introductionmentioning

confidence: 99%

“…The thrombin generation test (TGT) has emerged as a tool capable of assessing global hemostasis in a more physiological manner than conventional tests. [13][14][15][16][17] For this reason, TG testing with the calibrated automated thrombogram (CAT) method was used in the present study to evaluate the potential for TG in patients undergoing hemodialysis using CVCs.…”

Section: Introductionmentioning

confidence: 99%

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Effect of the expression of CD62P and thrombin generation on patients using central venous catheters for hemodialysis

et al. 2019

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The formation of thrombi in medical devices that come into contact with blood is a common cause of increased morbidity and mortality. Prolonged use of central venous catheters (CVCs) may cause high infection rates or compromise CVC patency due to thrombus development. In this study, we sought insights into possible changes in the hemostatic system during prolonged use of inserted CVCs for hemodialysis by assessing platelets by CD62P and CD41a expression and the potential for thrombin generation (TG). This study included patients with chronic renal failure who were undergoing hemodialysis three times a week using a CVC, and healthy subjects as controls. The participants were distributed into three groups: Group 1: clinically and laboratorially healthy individuals matched by sex and age to the patients (controls); Group II: patients who had completed 1 month of CVC insertion; and Group III: the same patients after they had completed 4 months of CVC insertion. Platelet activation analysis and TG evaluation were performed using blood samples obtained through two different accesses, that is, through a peripheral vein and directly from the CVC lumen. The data showed platelet activation and an increase in the generation of thrombin, particularly after 4 months of CVC use. The results also indicated that insertion of the catheter into the blood stream stimulated the intrinsic rather than the extrinsic pathway. Taken together, the data showed a direct relationship between the use of CVCs in hemodialysis patients and a state of hypercoagulability, most likely associated with endothelial damage and the contact of the medical device with blood components such as platelets and coagulation factors.

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“…Також не впливала на рівні РФД-15 та Галектину-3 наявність у хворих супутньої фібриляції передсердь. Значне та достовірне зниження рівня Р-селектину у хворих з фібриляцією передсердь повязане з прийомом пероральних антикоагулянтів, які блокують продукцію тромбоцитами Рселектину цими хворими [17]. Резюме.…”

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Influence of Demographic Indicators and Concomitant Pathology on the Level of New Biomarkers of Inflammation of GDF–15, P–Selectin and Galectin–3 in Patients with Hypertension in Combination with Type 2 Diabetes

Bilchenko¹

2019

Ukr. ž. med. bìol. sportu

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Biomarkers for the diagnosis of venous thromboembolism: D-dimer, thrombin generation, procoagulant phospholipid and soluble P-selectin

Abstract: Our results confirmed D-dimer as the main biomarker of VTE and speculated a role for sP-selectin. The impact of thrombin generation was limited and no role emerged for the PPL clotting time. These observations need to be confirmed in large management studies.

Cited by 22 publications

References 24 publications

Diagnostic Accuracy in Acute Venous Thromboembolism: Comparing D-Dimer, Thrombin Generation, Overall Hemostatic Potential, and Fibrin Monomers

Diagnostic Accuracy in Acute Venous Thromboembolism: Comparing D-Dimer, Thrombin Generation, Overall Hemostatic Potential, and Fibrin Monomers

Effect of the expression of CD62P and thrombin generation on patients using central venous catheters for hemodialysis

Influence of Demographic Indicators and Concomitant Pathology on the Level of New Biomarkers of Inflammation of GDF–15, P–Selectin and Galectin–3 in Patients with Hypertension in Combination with Type 2 Diabetes

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