Abstract Number: PB0670
Meeting: ISTH 2020 Congress
Background: Thrombin generation assays, such as Calibrated Automated Thrombogram (CAT), are fairly well recognised global haemostatic tests with much research and clinical data available. Data on clot waveform analysis (CWA) as a measurement of overall haemostatic function are emerging recently but its performance against other established assays is yet to be ascertained.
Aims: To study the correlation between CWA and CAT parameters across a range of INR in warfarin-treated patients.
Methods: Plasma samples were taken from patients on warfarin and their venous INRs were measured. TGA was performed using CAT platform with PPP Reagent, Thrombin Calibrator and FluCa kit (Diagnostica Stago). aPTT-based CWA parameters were generated using CS2100i coagulometer (Sysmex) with Dade Actin FSL reagent (Siemens). Both raw and adjusted (adjusted for baseline transmittance) CWA data were collected: Min1 (maximum velocity), Min2 (maximum acceleration) and Max2 (maximum deceleration). Pearson’s correlation test was used.
Results: 54 samples were included with a median INR of 4.27 (range: 1.55 – 7.38). For CAT, INR correlated negatively with endogenous thrombin potential (ETP) (r = -0.316, p = 0.003) and to peak thrombin (r = – 0.426, p = 0.0005). For CWA parameters, INR correlated negatively to Min1(r = – 0.378, p = 0.004), Min2 (r = – 0.363, p = 0.006) and Max2 (r = – 0.406, p = 0.002). CWA parameters demonstrated positive correlation with CAT results (Table 1), with the strongest correlation noted between adjusted CWA parameters and peak thrombin.
Conclusions: aPTT-based CWA parameters correlated negatively to INR and most of these parameters demonstrated moderate to strong correlation to CAT parameters, with the strongest correlation noted between adjusted CWA parameters and peak thrombin. These results affirm that aPTT-based CWA is a potential valuable tool to assess global haemostatic function.
|Adjusted CWA||Unadjusted CWA|
|Thrombin Generation Parameters||Min1||Min2||Max1||Min1||Min2||Max2|
|ETP||r = 0.609 p < 0.0001||r = 0.563 p < 0.0001||r = 0.641 p < 0.001||r = 0.230 p = 0.087||r = 0.326 p = 0.016||r = 0.437 p = 0.0009|
|Thrombin Peak||r = 0.803 p < 0.0001||r = 0.772 p < 0.0001||r = 0.822 p < 0.0001||r = 0.435 p = 0.001||r = 0.562 p < 0.0001||r = 0.648 p < 0.0001|
[Table 1: Correlations between CWA and thrombin generation parameters]
To cite this abstract in AMA style:Cheong MA, Tan CW, Wong WH, Kong MC, See E, Yeang SH, Koh SK, Shim YT, Lee LH, Ng HJ. A Correlation of Thrombin Generation Assay and Clot Waveform Analysis in Patients on Warfarin [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/a-correlation-of-thrombin-generation-assay-and-clot-waveform-analysis-in-patients-on-warfarin/. Accessed November 26, 2020.
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