Thrombin generation test for evaluation of antiplatelet treatment in patients with coronary artery disease after percutaneous coronary intervention

Berezovskaya, G. A.; Smirnova, Olga A.; Малев, Э. Г.; Khromov-Borisov, N. N.; Клокова, Е. С.; Карпенко, М. А.; Papayan, L.; Nn, Petrishchëv

doi:10.1080/09537104.2017.1294680

Cited by 14 publications

(13 citation statements)

References 30 publications

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“…Antiplatelet medications have, however, been shown to be without effect on thrombin generation. 38 Also, as AAS abuse is characterized by intake of several compounds taken intermittently, it is difficult to transfer our results to other cohorts of AAS abusers.…”

Section: Discussionmentioning

confidence: 93%

Procoagulant State in Current and Former Anabolic Androgenic Steroid Abusers

et al. 2018

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Background Anabolic androgenic steroid (AAS) abusers are considered at increased risk of cardiovascular morbidity and mortality. We hypothesized that current and former AAS abuse would induce a procoagulant shift in the haemostatic balance. Methods Men 18 to 50 years of age were included as current AAS abusers, former AAS abusers or controls. Morning blood samples were collected after overnight fasting. Thrombin generation (lag time, time to peak, peak height, and endogenous thrombin potential [ETP]) and coagulation factor II (prothrombin), VII and X, antithrombin, protein C, free protein S and tissue factor pathway inhibitor (TFPI) were assessed. Groups were compared by ANOVA or Kruskal–Wallis test and probabilities were corrected for multiple comparisons. Associations were evaluated using linear regression models. Results ETP was increased around 15% in current (n = 37) and former (n = 33) AAS abusers compared with controls (n = 30; p < 0.001). Prothrombin and factor X were increased ≥10% in AAS abusers and prothrombin was a predictor of ETP (p < 0.0005). Lag time and time to peak were increased 10 to 30% in current AAS abusers (p < 0.001) and associated with higher concentrations of TFPI, antithrombin, protein C and protein S (p < 0.0005; = 0.005). Multivariate linear regression, with all coagulation inhibitors as covariates, identified TFPI to be independently associated with lag time and time to peak (p < 0.0005). Conclusion Thrombin generation is augmented in current and former AAS abusers, reflecting a procoagulant state, with altered concentrations of coagulation proteins. Prospective studies are needed to clarify whether these findings translate into an increased thrombotic risk in AAS abusers potentially even after cessation.

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Section: Discussionmentioning

confidence: 93%

Procoagulant State in Current and Former Anabolic Androgenic Steroid Abusers

et al. 2018

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“…The function of coagulation factor can be reflected by R value, K value and MA value. When R value and K value are increased and MA value is decreased, coagulation factor and platelet coagulation acti vity are both decreased (21). It is indicated that the overall coagulation function of patients was better in the experimental group than that in the control group.…”

Section: Discussionmentioning

confidence: 99%

Analysis of thrombelastogram-guided medication in patients with coronary heart disease after percutaneous coronary intervention

Chang

et al. 2019

Exp Ther Med

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Effects of thrombelastogram-guided (TEG-guided) clopidogrel and aspirin on major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) were investigated. A retrospective analysis was performed on 203 patients undergoing PCI interventional therapy in the Cardiovascular Medicine of Weihai Central Hospital from February 2015 to September 2016. The patients were treated with clopidogrel and aspirin for anti-thrombus therapy. Among them, 104 patients who had TEG detection of anticoagulant effects for guiding medication were the experimental group, and 99 patients without TEG detection for guiding medication the control group. The coagulation function and the platelet inhibition rate of patients after medication were evaluated and compared between the two groups. The incidence of MACE and bleeding events of patients was counted during three months of follow-up. Patients in the experimental group had higher R (coagulation reaction time) value and K (blood clot formation time) value than those in the control group after treatment (P<0.05), and lower MA (maximum amplitude) value than those in the control group (P<0.05). Patients in the experimental group had higher postoperative platelet inhibition rate than those in the control group (P<0.05). Patients in the experimental group had lower incidence of MACE and bleeding events than those in the control group (P<0.05). Coronary heart disease (CHD) patients after PCI with the TEG-guided dose adjustment of clopidogrel have more satisfactory treatment effects than patients without the TEG guidance. TEG makes the treatment of patients more targeted and is worthy of promotion.

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“…Even though antiplatelet therapy, like aspirin and clopidogrel, do not affect coagulation factors, the effect of 10.3389/fcvm.2022.1033416 these therapies on thrombin generation were studied in PRP as well as PPP. A case-control study showed that patients with CAD followed by PCI who were treated with standard dosage of dual antiplatelet therapy with aspirin and clopidogrel had significant longer time to thrombin peak, decreased thrombin peak height and ETP than controls in PRP (181). Velocity of thrombin generation was most impaired in patients.…”

Section: Antiplatelet Therapymentioning

confidence: 99%

Thrombin generation assays to personalize treatment in bleeding and thrombotic diseases

Valke

Rijpma

Meijer

et al. 2022

Front. Cardiovasc. Med.

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Treatment of bleeding and thrombotic disorders is highly standardized and based on evidence-based medicine guidelines. These evidence-based treatment schemes are well accepted but may lead to either insufficient treatment or over-dosing, because the individuals’ hemostatic properties are not taken into account. This can potentially introduce bleeding or thrombotic complications in individual patients. With the incorporation of pharmacokinetic (PK) and pharmacodynamic (PK-PD) parameters, based on global assays such as thrombin generation assays (TGAs), a more personalized approach can be applied to treat either bleeding or thrombotic disorders. In this review, we will discuss the recent literature about the technical aspects of TGAs and the relation to diagnosis and management of bleeding and thrombotic disorders. In patients with bleeding disorders, such as hemophilia A or factor VII deficiency, TGAs can be used to identify patients with a more severe bleeding phenotype and also in the management with non-replacement therapy and/or bypassing therapy. These assays have also a role in patients with venous thrombo-embolism, but the usage of TGAs in patients with arterial thrombosis is less clear. However, there is a potential role for TGAs in the monitoring of (long-term) antithrombotic therapy, for example with the use of direct oral anticoagulants. Finally this review will discuss controversies, limitations and knowledge gaps in relation to the introduction of TGAs to personalize medicine in daily medical practice.

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Thrombin generation test for evaluation of antiplatelet treatment in patients with coronary artery disease after percutaneous coronary intervention

Cited by 14 publications

References 30 publications

Procoagulant State in Current and Former Anabolic Androgenic Steroid Abusers

Procoagulant State in Current and Former Anabolic Androgenic Steroid Abusers

Analysis of thrombelastogram-guided medication in patients with coronary heart disease after percutaneous coronary intervention

Thrombin generation assays to personalize treatment in bleeding and thrombotic diseases

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